Medical Research

At The Back Clinic we use the most advanced, researched and documented methods available for dealing with acute and chronic back pain. Below are some extracts from some of the relevant research papers, and responses to some of the most frequently asked questions. There is also a full list of research articles that support our approach to the treatment of back pain. If you would like copies of the relevant articles please call us.

Do MedX® results vary according to diagnosis?

It appears that they do not - we see patients with a wide variety of diagnoses and achieve excellent results with the majority of them.

The research...

A study made a comparison of treatment of 412 patients with chronic back pain at two separate centres using the same (MedX®) treatment protocols and outcome measures with a one-year follow up. [more...]

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Does MedX® work better at strengthening the lower back than other exercise devices?

Yes, much better. MedX® uses a patented method to immobilise the pelvis and isolate the lumbar extensor muscles. Research has shown that pelvic stabilisation is indispensable when strengthening the lumbar extensor muscles.

The research...

A study compared resistance training with and without pelvic stabilisation in a group of 47 men and 30 women. [more...]

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How do we know that the strength measurement of the MedX® Lumbar Extensor Machine is reliable?

The MedX® Lumbar Extensor Machine is the first and only machine capable of isolating the lumbar extensor muscles, and producing an objective measurement of a patient's lower back strength and range of motion.

The research...

A study evaluated the reliability and variability of repeated measures of isometric lumbar extension strength... [more...]

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Does strength increase correlate with pain decrease?

Yes, it appears that there is a good association between improved strength and function and reduced pain.

The research...

A study by Risch looked at the effects of exercise for isolated lumbar extensor muscles in 54 chronic low back pain patients. [more...]

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What sort of results does MedX® treatment produce?

Several studies have documented outcomes for groups of chronic low back pain patients treated using intensive specific exercise using a firm pelvic stabilisation (MedX® Lumbar Extensor Machine).

The research...

Risch's study (SPINE 1993) reported that specific exercise for isolated lumbar extensor muscles substantially increased low-back strength in chronic low back pain patients versus a wait-listed control group. [more...]

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Are the benefits lasting?

Studies report that the benefits of treatment are sustained.

The research...

Nelson reported that at 1 year follow up to 94% of patients with good or excellent results from their treatment reported maintaining their improvement. [more...]

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Can treatment at The Back Clinic be an alternative to surgery?

Most specialists in the UK will these days recommend surgery only in very clear-cut cases. However, research from the US does suggest that the treatment regime that we offer at The Back Clinic might sometimes be a viable alternative.

The research...

A recent study followed the progress of a group of 38 patients who had been recommended by their doctor for surgery but first completed a course of treatment using the MedX® Lumbar Extensor Machine. [more...]

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Other useful extracts

Management of Back Pain
"Several studies indicate the effectiveness of vigorous strengthening of paraspinal and trunk muscles on pain and even disc surgery. Different underlying pathologies seem to respond equally well to this concept"
Dept of Physical Medicine and Rehabilitation, University Hospital, Vienna.

The effect of trunk muscle exercises in patients over 40 years of age with chronic low back pain
"In older patients with Chronic Low Back Pain (…) it was confirmed that trunk muscle strengthening exercises are useful for increasing muscle strength and improving symptoms…"
Handa, Yamamoto et al, Dept of Orthopaedic Surgery, Kochi Medical School, Japan

Effect of three different training modalities on the cross-sectional area of the lumbar multifidus muscles in patients with low back pain
"Treatment consisting of stabilisation training combined with an intensive lumbar dynamic-static strengthening programme seems to be the most appropriate method of restoring the size of the multifidus muscles"
Daneels et al Dept of Rehabilitation Sciences and Physical Therapy, Faculty of Medicine, Ghent University, Belgium

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General List of Research Papers

A Rational Approach to Low Back Pain
(Nelson, The Journal of Musculoskeletal Medicine, May 1993)

Restorative Exercise for Clinical Low Back Pain
(Leggett, Mooney et al., SPINE, 1999)

Can Spinal Surgery be Prevented by Aggressive Strengthening Exercises? A Prospective Study of Cervical and Lumbar Patients
(Nelson et al., Archive of Physical Medicine & Rehabilitation, Jan 1999)

Lumbar Strengthening in Chronic Low Back Pain Patients
(Risch et al., SPINE, Feb 1993)

Comparison of Two Restraint Systems for Pelvic Stabilisation during Isometric Lumbar Extension Strength Testing
(Graves et al., JOSPT, 15;1, Jan 1992)

The Clinical Effects of Intensive, Specific Exercise on Chronic Low Back Pain: A Controlled Study of 895 Consecutive Patients with 1-Year Follow Up
(Nelson at al., Orthopedics, Oct 1995)

Changes in Isometric Strength and Range of Motion of the Isolated Lumbar Spine following Eight Weeks of Clinical Rehabilitation
(Russell, Highland, Vie, Dreisinger)

Changes in Isometric Strength and Range of Motion of the Isolated Cervical Spine After Eight Weeks of Clinical Rehabilitation
(Russell, Highland, Vie, Dreisinger, SPINE, Jun 1992)

The Effect of Workplace Based Strengthening on Low Back Injury Rates: A Case Study in the Strip Mining Industry
(Mooney et al., The Journal of Occupational Rehabilitation, 1995)

Pelvic Stabilisation During Resistance Training: Its Effect on the Development of Lumbar Extension Strength
(Graves et al., Archive of Physical Medicine & Rehabilitation, Feb 1994)

Limited Range-of-Motion Lumbar Extension Strength Training
(Graves et al., Medicine and Science in Sports and Exercise, 1992)

Quantitative Assessment of Full Range-of-Motion Isometric Lumbar Extension Strength
(Graves et al., SPINE, Apr 1990)

A Prospective Study of Centralisation of Lumbar and Referred Pain
(Donelson et al., SPINE, 22;10, 1997)

Physiological Evaluation of ProfessionalWater-Skiers
(Leggett et al., The Journal of Strength and Conditioning Research, 8;1, 1994)

On the Dose of Therapeutic Exercise
(Mooney., Orthopaedics, 15;5, May1992)

New Approach to Low Back Evaluation and Training;
(Mooney et al., Central Florida Physician, July 1989)

Effect of Resistance Training on Lumbar Extension Strength
(Pollock et al., The American Journal of Sports Medicine, 1989)

Effect of 12 and 20 Weeks of Resistance Training on Lumbar Extension Torque Production
(Carpenter, Graves, Pollock, Leggett, Foster, Holmes, Fulton, Physical Therapy, Aug 1991)

Comparison of Female Geriatric Lumber-Extension Strength: Asymptomatic Versus Chronic Low Back Pain Patients and their Response to Active Rehabilitation
(Holmes, Leggett, Mooney, Nichols, Negri, Hoeyberghs, The Journal of Spinal Disorders, Jan 1996)

Frequency and Volume of Resistance Training: Effect on Cervical Extension Strength
(Pollock, Graves, Bamman, Leggett, Carpenter, Carr, Cirulli, Matkozich, Fulton, Archive of Physical Medicine & Rehabilitation, Oct 1993)

Evaluation & Treatment of Low Back Pain
(Mooney et al., Clinical Symposia, Jan 1996)

Effect of Resistance Training Volume on Strength and Muscle Thickness
(Starkey et al., Medicine and Science in Sports & Exercise, Mar 1996)

Effect of Resistance Training on Lumbar Extension Strength
(Pollock et al., American Journal of Sports Medicine, Jan 1989)

Effect of Training Frequency and Specificity on Isometric Lumbar Extension Strength
(Graves et al., SPINE, Jun 1990)

Effect of Reduced Frequency of Training and Detraining on Lumbar Extension Strength
(Tucci et al., SPINE, Jul 1992)

Relationship between Myoelectric Activity, Strength and MRI of Lumbar Extensor Muscles in Back Pain Patients and Normal Subjects
(Mooney et al., Journal of Spinal Disorders, Feb 1997)

A Randomized Clinical Trial of Exercise and Spinal Manipulation for Patients with Chronic Neck Pain
(Bronfort, Evans, Nelson et al. SPINE, April 2001)

Management of Back Pain
Quittan, Disability Rehabilitation, May 2002

Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain.
Denneels et al, British Journal of Sports Medicine, June 2001

Physiotherapy in lumbar disc herniation
Stoll et al, Ther Umsch, August 2001

The effect of trunk muscle exercises in patients over 40 years age with chronic back pain
Hand, Yamamoto et al, Journal of Orthopaedic Science, 2000

The percentage improvement in Pain Scale as a measure of physiotherapy treatment effects
Gridley, van Dolder, Australian Journal of Physiotherapy, 2001