Manniche C
Ugeskr Laeger. 1989 Aug 7;151(32):2009-12.
The training therapy, which most back therapists consider an indispensable basic element in attempts to treat chronic low back pain, is reviewed, with an historical survey and description of the basic research in the field. Epidemiological studies show concurrence between chronic low back pain and reduced endurance of the back musculature and that the combination of a weak back and a back-straining occupation greatly increases the risk of low back trouble. On the basis of these studies, it is concluded that use of isometric back exercises in low dosage, which are central to the internationally acknowledged Swedish back school, only results in strengthening and increased endurance of the back muscles with difficulty. The author recommends introduction of intensive dynamic back extensor exercises which result in strength and endurance of the muscles. The back muscle training ought to be lifelong; thus, the exercises must be simple, learned over a longer period of time, so that the patients perceive the training as a natural and necessary part of everyday life.