Effects of aquatic backward locomotion exercise and progressive resistance exercise on lumbar extension strength in patients who have undergone lumbar diskectomy.

OBJECTIVE To compare the effects of aquatic backward locomotion exercise and progressive resistance exercise with a machine on lumbar extension strength in patients who have undergone diskectomy for a lumbar disk herniation. DESIGN Prospective comparative study. SETTING Department of Kinesiology at a state university. PARTICIPANTS Male patients (N=30) with disk herniation at spinal levels L3 to S1 completed this study as subjects. INTERVENTION After the diskectomy for a lumbar disk herniation, all patients had 6 weeks of rest time. At the end of the rest period, the aquatic backward locomotion exercise and progressive resistance exercise groups, respectively, started first 6 weeks of underwater training and lumbar extension training twice per week. After completion of the first 6-week training, subjects participated in a second 6-week training. After the whole 12-week training, subjects had no training for 6 weeks (detraining) and a follow-up 6-week training (retraining). The control (CON) group did not undergo any training. MAIN OUTCOME MEASURES For each test, maximum voluntary isometric lumbar extension strength was measured in 7 trunk positions (72 degrees , 60 degrees , 48 degrees , 36 degrees , 24 degrees , 12 degrees , and 0 degrees of the trunk angle). RESULTS The progressive resistance exercise and aquatic backward locomotion exercise groups showed increases in lumbar extension strength after the first 6-week training, although they were not statistically different from the CON group. After a second 6-week training, the progressive resistance exercise and aquatic backward locomotion exercise groups showed statistically significant increases in their strength levels as compared with the CON group. After the detraining period, the strength levels of the progressive resistance exercise and aquatic backward locomotion exercise groups did not statistically differ from the CON group. After the retraining period, the progressive resistance exercise and aquatic backward locomotion exercise groups showed increases in their strength levels, which were different from that of the CON group. CONCLUSIONS The results obtained suggested that the aquatic backward locomotion exercise is as beneficial as progressive resistance exercise for improving lumbar extension strength in patients after lumbar diskectomy surgery.