DO MEDX® RESULTS VARY ACCORDING TO DIAGNOSIS? It appears that results do not vary depending on diagnosis.

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.

Overall response was similar at all stages between the two centres and similar proportions of participants at each site demonstrated significant improvement. The study showed that a defined and focused program specifically designed to restore functional deficits rather than manage pain has an excellent opportunity to provide effective care unrelated to medical diagnosis. Leggett et al., SPINE 1999

Another published study looked at the outcomes for 627 chronic low back pain patients who completed a program whose primary treatment was intensive, specific exercise using firm pelvic stabilization to isolate and rehabilitate the lumbar spine musculature. The study found that "diagnosis did not significantly affect outcome". Nelson et al
Symptoms treated in both of the above studies included:
• Low Back Strain / Mechanical Back Pain
• Degenerative Disc Syndrome
• Prolapsed / "Slipped" Disc
• Spondylolisthesis
• Sciatica
• Myofascial Syndrome
• Spinal Stenosis

DOES MEDX® WORK BETTER AT STRENGTHENING THE LOWER BACK THAN OTHER EXERCISE DEVICES? Yes, much better. MedX® uses a patented method to immobilize the pelvis and isolate the lumbar extensor muscles. Research has shown that pelvic stabilization 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. The data showed that post training isometric torque values describing isolated lumbar extension strength improved only for the group that trained with pelvic stabilisation and not at all for the group without pelvic stabilisation (using systems such as Cybex and Nautilus) when compared to the (no exercise) control group. Graves et al. Archive of Physical Medicine & Rehabilitation in February 1994

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 made at different joint angles in 56 men and 80 women. The data indicated that repeated measures of isometric lumbar extension strength are highly reliable and can be used for the quantification of isometric lumbar extension strength through a range of motion.
Graves et al., SPINE 1989

A 1990 Study found that the MedX Lumbar Extensor Machine provides a safe, valid and reliable tool with which to measure changes in strength and range of motion in patients with a variety of lumbar disorders (e.g. lumbar strain, herniated discs, degenerated discs, spondylolisthesis, and others) Russell et al. North American Spine Society Annual Meeting, 1990

DOES AN INCREASE IN STRENGTH CORRELATE WITH A 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.

Results showed a significant increase in isometric lumbar extension strength for the treatment group and a significant reduction in reported pain compared with the control group.Risch et al., SPINE 1993

A study by Nelson that looked at outcomes for 627 chronic low back pain patients who completed a programme whose primary treatment was intensive, specific exercise using firm pelvic stabilization to isolate and rehabilitate the lumbar spine musculature found that 76% of patients experienced "both substantial pain relief and substantial improvement in strength" compared to a control group of 107 patients that were not treated. Nelson et al. ORTHOPEDICS, Oct 1995

A prospective, controlled study by Manniche found that a course of high intensity lumbar extension exercise produced a 70% decrease in reported subjective pain for chronic low back patients. Manniche et al. PAIN 1991

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.

Additionally, increased strength was associated with perceived improvements in physical and psychosocial functioning. Risch et al., SPINE 1993

Nelson et al. reported that 76% of patients completing the treatment programme had excellent or good results (definition: "both substantial pain relief and substantial improvement in strength")
Nelson et al. ORTHOPEDICS October 1995

ARE THE BENEFITS OF STRENGTHENING WITH A LUMBAR MEDX® MACHINE 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.

Overall 70% of patients who completed the treatment obtained substantial relief from their symptoms for at least one year versus 29% of the control group (assessed as being suitable for treatment but who declined treatment).

Nelson et al. ORTHOPEDICS October 1995. Leggett et al. reported that benefits (as measured by SF-36 scores) achieved in a two-centre study of 412 patients undergoing treatment using the MedX® Lumbar Extensor Machine were maintained at one year follow up. Leggett et al. SPINE, 1999 - COPY AVAILABLE

CAN TREATMENT WITH A MEDX LUMBAR MACHINE BE AN ALTERNATIVE TO SURGERY? In cases where surgery is a possibility, studies have shown that significant improvements can be achieved with the MedX, and thereby avoiding surgery.

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.

The study reported that at 16 month follow up 81% of patients reported themselves to be "excellent" or "good" and that 92% of the patients were able to avoid surgery. Nelson, Carpenter et al. Archives of Physical Medicine and Rehabilitation, 1999

OTHER ARTICLES OF INTEREST
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 3 DIFFERENT TRAINING MODALITIES ON THE CROSS-SECTIONAL AREA OF THELUMBAR 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