Literature Reviews

Summary and Perspective of Recent Literature

Matsudaira K. Et al. (2015). Can standing back extension exercise improve or prevent low back pain in Japanese care workers? Journal of Manual and Manipulative Therapy; Published Online Jan 2015. DOI:

To determine if a standing back extension exercise (one stretch) can improve or prevent low back pain (LBP) in Japanese care workers.

A single-centre, non-randomized controlled study.

One health care facility for the elderly: Numbu Kohoen, Japan.

Japanese care workers at the facility who had direct patient care were assigned into one of two groups:  workers on the first floor into the control group and workers on the second floor to the intervention group.  No inclusion criteria beyond working in direct patient care on one of the two facility floors was mentioned. The subjects’ exclusion criteria were:

  • Difficulties in participating due to medical causes (spinal stenosis, rheumatoid arthritis, and ankylosing spondylitis) or other personal reasons

The subjects were assigned to either the “one stretch” standing extension group or the control group based on the facility floor on which they worked. All subjects in both groups received an exercise manual.  The manual outlined how to properly do a standing back extension, and also provided some evidence-based information on self-management of LBP and risk factors (psychosocial factors and fear avoidance).

The "one stretch" intervention group received an exercise manual, a 30-minute seminar by an orthopedist that outlined the manual and the standing extension exercise, and performed the standing extension exercise together at their daily meeting in order to promote regular exercise.

The control group received the same exercise manual, and the instructions were to "Practice active extension of the low back after lifting something heavy, keeping a forward flexion posture, or sitting still for an extended period."  Each control subject was left on their own to complete the standing extension exercise as they saw fit.

Main Outcome Measures:  Data was collected at baseline and after one year through a self-administered questionnaire.  Outcome measures were:

  • The subjective improvement of LBP from baseline (improved, no change, worse)
  • Compliance with the exercise (good/poor)

Main Results:

For the full results of this study, including graphs, please see the attached PDF article.