Exercise Prescription and the Back

From The Critics

Reviewer: Ronald F. Bybee, MSPT, DipMDT(University of Texas at El Paso)
Description: This is an introduction to the issues of exercise and low back pain.
Purpose: The authors seek to provide exercise science students a background relating the place of exercise in the treatment of low back pain. The book begins with a section on anatomy, biomechanics, and function of the back. Part two discusses diagnosis and incidence of low back pain with an emphasis on sports activities. Part three reviews a number of exercise protocols, speaks to aquatic therapy, and addresses the efficacy of exercise in low back pain.
Audience: The editor suggests that this book could be an adjunct text in physical therapy, athletic training, and exercise science. It is further implied that because of the research based approach, it could also serve as a reference for the these disciplines and for physicians.
Features: The book is well written at a basic level for easy understanding. A comprehensive index allows readers easy access to specific topics. The title is a bit misleading in that the book does not address exercise prescription for the back, but deals exclusively with exercise for low back pain. A major problem with the proposition is that the efficacy of exercise for the treatment of low back pain is poorly supported in the literature (van Tulder M, et al. "Exercise therapy for low back pain." Spine, Vol. 25, No. 21, pp 2784-96; Koes BW, et al. "Physiotherapy exercises and back pain: A blinded review." British Medical Journal, 1991, 302:1572-6). There are no studies cited that support the efficacy of the Feldenkrais and Alexander techniques or aquatic exercise for the low back.
Assessment: The book is recommended as an adjunct for physical therapy, athletic training, and exercise science. It may serve as a reference for undergraduates in athletic training and exercise science as they consider low back pain; however, physical therapy students at the graduate level would be better prepared by more comprehensive texts such as Kirkaldy-Willis's Managing Low Back Pain, 4th Edition (Churchill Livingstone, 1999); Twomey's Physical Therapy of the Low Back, 3rd Edition (Churchill Livingstone, 2000); and Donatelli's Orthopaedic Physical Therapy (Churchill Livingstone, 1994).

2 Stars from Doody