Efficacy of Abdominal trunk muscle-strengthening exercise and trunk stability assessment for chronic low back pain and locomotive syndrome in the elderly

Abstract

Exercise is the most common and important intervention for chronic low back pain (CLBP) and locomotive syndrome (LS). We have developed an innovative exercise device (RECORE^®) for the abdominal trunk muscles that also measures muscle strength in a sitting position without the need for trunk movement. The device, which is easy for elderly patients with CLBP and/or LS to use, allows for lumbar stabilization exercise under pressure. Our studies have demonstrated that the strengthening exercises using the device both activate and increase the strength of the diaphragm, abdominals, and pelvic-floor muscles. The abdominal core can be described as a muscular box with the abdominals in the front and sides, the diaphragm as the roof, and the pelvic floor as the base. The strength of the abdominal trunk muscles, as measured using the device, is created by the contraction of all deep and superficial abdominal core muscles to increase intra-abdominal pressure, thus creating a semirigid cylinder surrounding the spinal column, which is capable of stabilizing the trunk and relieving some of the imposed stress on the vertebral column. This mechanism improves patients' CLBP and mobility function. Our studies have demonstrated that muscle weakness in the elderly was associated with the presence of CLBP and with a history and risk of falling and osteoporotic vertebral fracture. Our prospective intervention study showed that the strengthening exercise using the device was effective in improving the strength of the abdominal trunk muscles, the pain intensity of CLBP, and mobility.