Physical progress and residual impairment quantification after functional restoration: Part iii: Isokinetic and isoinertial lifting capacity

There is currently a great need to expand the knowledge base of various functional capacity measures used in the rehabilitation of chronic low back pain ICLBP.i patio, its, Jn the eurront &tudy, tha functions I performance of lift:ng capacity differences among four separate CLBP patient groups ware examined by using standardized isokinetic and isoinertial i.fting performance measurements. One hundred ninety-three consecutive patients were assessed at tfiree separate points in time: at initial evaluation;PR?). at edmission to the intensive 3-week phase of a functional restoration program (ADM!, and after program discharge und ful* faw up (FU) (an average of 12 wee^s leterl, Group 1 (n ¦¦ Z6h consisted of postdiscectomy CLBP men; Group £ (n = 91J consisted of noneurgical CLBP men; Group 3 (n -¦ i?J constated of postdiscectomy women; and ?roup 4 [n = 591 consisterf rtf non surgical women. Results comparing admission scores to postdlscharge scores revealed that all four groups demonstrated a Significant increase <P < 0.0T] in Liftask and prtjgms.alVe isoinertial llftirsy evaluation performance. Increases In performance were v-dually identical for ne-noporalive and postoperative patients, with postrfiscectomy men arid women actually achieving peak Isokinetic lifting forces higher than unaperated patients at the program's conclusion. This- achievement in human performance: was not found for [.he progress™ isoinertial iifting evaluation last, Overall, these findings illustrate the utility of quantitative functional capacity measures., and provides objective evidence of ihe gams achieved by the patients. If their isDkinctic lifting is vlawad as a functFonai paradigm for lumbar spine activities of daily lifting (as running reJates to ADLs Tor knees and ankles), the post-treatment achievement of normal (or near-nor- ¦TialHifting capacity at maximum medical;mprovamfint is noteworthy, Considering that most patients demonstrate significant postrehabilitaticn residua) impairment ot lumbar mobility and strength, the achievement of normal Overall bqdy function attests to the body's ability to maintain adequate performance levels by substitution and cornpensat;on for impaired spinal regionsj much as it compensates for degeneration or Instate ily in extremity [olnts. These results also clearly demonsi rate the effectiveness of a functional restoration program to enhance gHlne in human performance in CLBP patients with and without prior surgery. As important, these results provide a useful database for future comparison of Liftask and PILE performance by chronic CLBP patients before and after an effective rehabifitation program.