Analysis of strength tests and resistive exercises commonly used for low-back disorders

Using a modeling approach the conventional sit-up, the double straight-leg lowering, and prone trunk extension, the authors have shown these to have limitations as tests of maximum trunk flexion and extension strength and as modes of resistive exercise. These maneuvers are poor discriminators of trunk muscle strength, and they lack the range of resistance necessary to cover the spectrum of human trunk muscle strength capability. Use of manually handled weights can improve the above clinical tests and resistive exercise methods. As a result of selective positioning of the weights, variable resistance above and below that provided by the body segments alone can be achieved. The partial sit-up may be appropriate only for patients with significant trunk flexion weakness, and the straight head-trunk sit-up may be useful as a more strenuous test and resistive exercise. Rationale and derivations of the rigid-body equilibrium equations, as well as some of the limitations and assumptions associated with the modeling approach, are presented.