Chronic low back pain (CLBP) is common, expensive, and acknowledged as multifactorial in nature. However, deconditioning of the lumbar extensor musculature may be a common factor. Thus specific resistance exercise is frequently recommended. Many resistance exercises for the lumbar extensors exist, although recent evidence suggests that isolated lumbar extension (ILEX) resistance training may best for conditioning these muscles. Thus this review sought to examine the use of ILEX resistance training in participants with CLBP to provide a best-evidence synthesis for practitioners and clinicians. Results indicate that ILEX resistance training results in significant and meaningful improvements in perceived pain, disability, and GPOs, as part of a multiple intervention or stand-alone approach. A low frequency (once per week) yet high intensity of effort (to momentary muscular failure) approach using either full or limited range-of-motion ILEX resistance training seems to be sufficient and best for significant and meaningful outcomes. Limited comparative studies between ILEX resistance training and other specific exercise approaches exist; however, only limited evidence supports ILEX resistance training as being more effective.
These findings highlight ILEX resistance training as effective for significant and meaningful improvements in perceived pain, disability, and GPOs for CLBP participants. Further research should elucidate comparisons between ILEX resistance training and other specific exercise approaches and should clarify whether lumbar extensor conditioning is the mechanism accountable for the improvements reported.