Is de Backstretcher bewezen effectief?
Regelmatig gebruik van de Backstretcher leidt tot aantoonbare verbetering binnen enkele weken.
Uit meerdere praktijkgerichte onderzoeken en pilots blijkt dat de Backstretcher een duidelijk positieve werking heeft bij een brede groep mensen met niet-specifieke rugklachten, variërend van mild tot chronisch ernstig. De kern van deze effectiviteit ligt in het antikyphotische en spierontspannende effect, waarmee belangrijke oorzaken van rugpijn direct worden aangepakt.
Alle onderzoeken
The Backstretcher®
Back complaints are an enormous medical, social and economic problem. The Centraal Bureau voor
de Statistiek (=CBS, Dutch Central Statistical Office) concluded in its most recent report with regard
to chronic disorders, that chronic back complaints can be found in third place with some 800,000
people suffering from them. In the (working) age group of 35–65 years old, it is the most common
disorder.
By order of the Ziekenfondsraad (Dutch Medical Insurance Board), the Vrije Universiteit (Free
University of Amsterdam) calculated that the social cost involved with chronic back complaints is
conservatively estimated at 9.3 billion Dutch guilders a year. Of this amount, 700 million is spent on
primary medical costs and 8.6 billion is consumed by claims to social legislation and loss of
productivity.
The College toezicht sociale verzekeringen (=Ctsv, Dutch Board for Control of Social Insurances)
concluded, as part of a long-term international study, that 50% of the people who end up in the
ZW/WAO (Dutch Health Law/Dutch Disablement Insurance Act), already suffered from back
complaints with a negative effect on the work performance, two years before their resignation.
This conclusion is not only significant because it gives insight into the loss of productivity, but also
because the results of the study suggest that taking away “work restricting” back complaints should
contribute to keeping the people in question working.
Reason enough to extend the available arsenal for fighting back complaints and the socio-economic
problems that go along with them.
From epidemiological data about non-specific back complaints, it becomes clear that in
approximately 75% of the cases there is intensified thoracic kyphosis and the hypertonia of the
paravertebral muscles that goes along with it.
The Backstretcher is a wooden back bench with an antikyphotic and muscle-relaxing effect. In this
way, it deals with the most common aetiological factors of back pain.
The Backstretcher was developed in England by the kinesio-therapist Neil Summers, in cooperation
with several orthopaedic surgeons and physiotherapists, in which the optimum form has been
established along the path of clinical empiricism.
The Backstretcher is used by lying on it for fifteen minutes a day, which means this is a passive form
of therapy.
The Backstretcher was successfully brought onto the market in England at the beginning of 1995 and
won several important awards, such as The Best New Health & Medical Product.
1. First impression of the working mechanism (survey)
The Backstretcher was demonstrated to 663 physiotherapists and manual therapists, the indication
“non-specific back complaints” was mentioned and they were asked for their first impression:
Conclusion:
The first impression of the experts is positive. The most valuable factor is that only 13% of the
663 respondents have a negative impression. This can, incidentally, be explained by the different
movements within the occupational group.
2. Chronically severe back complaints6
For 12 patients, who are being treated for chronically severe non-specific back complaints by a general
practitioner (J. van Niekerk) and a physiotherapist (M. van Straten), the Backstretcher has been added
to the treatment protocol, in which the emphasis was already on anti-kyphosis, under the direction of a
physiotherapist.
After two weeks, 11/12 of the patients showed drastic improvement, 3 patients did not even have any
complaints whatsoever. The results may be summarized as follows:
Complaint score
| Extremely severe | Severe | Moderate | Slight | Very slight | None | |
|---|---|---|---|---|---|---|
| Beforehand | 4 | 5 | 3 | |||
| After 2 weeks | 1 | 1 | 1 | 3 | 3 | 3 |
For 4 patients, the evaluation was extended by two weeks and further improvement could be observed:
Complaint score
| Extremely severe | Severe | Moderate | Slight | Very slight | None | |
|---|---|---|---|---|---|---|
| After 2 weeks | 1 | 1 | 2 | |||
| After 4 weeks | 1 | 1 | 2 |
Currently, 13 to 15 months after the commencement of this pilot study, the Backstretcher is still used
by the (former) patients. So far, no patients have reported to either general practitioner or physiotherapist
with recurrence.
The conclusion of this research and its follow-up is that the Backstretcher has a positive effect on
most patients with chronically severe back complaints — under which antikyphosis is considered to be
indicated — and with regular use this effect can continue for years.
3. Chronic moderate back complaints7
For 28 people taking part in the company fitness programme of the Provinciehuis (County Hall)
Utrecht and suffering from low back complaints (subjective) and intensified thoracic kyphosis
(objective), the Backstretcher was added to the regular company fitness programme for a period of 4
weeks.
In this study, carried out by the physiotherapist P. Verweij, not only the degree of back complaints was
looked into, but also the improvement of work restriction, if this existed. This is done with an eye on
the importance of productivity and in order to prevent resignation.
The most important results are listed in the table below:
Key results
| Total number | Complaints worse | Complaints unchanged | Complaints improved <50% | Complaints improved >=50% | Complaints disappeared | |
|---|---|---|---|---|---|---|
| Back complaints | 28 | 0 (0%) | 3 (11%) | 2 (7%) | 21 (75%) | 2 (7%) |
| Work restriction | 21 | 2 (10%) | 1 (5%) | 0 (0%) | 3 (14%) | 15 (71%) |
| ADL restriction | 24 | 0 (0%) | 2 (8%) | 1 (4%) | 9 (38%) | 12 (50%) |
Conclusion from these results is that the Backstretcher causes an very relevant improvement of the
complaints with approximately 90% of the people with chronic moderate complaints. These results
confirm the findings of the study with severe patients.
However, the additional functional improvement is extremely important: of the people who were
formerly restricted in their work, over 80% is free of restrictions at the end of the research period.
4. Bechterew’s disease8
The Backstretcher was applied in a group of 18 patients with long-present Bechterew’s disease. This
patient group has existed for over a year and takes part in an intensive physio-therapeutical
programme. The patients have been suffering from this disease for an average of 15 years (spread
4–25 years).
This group originally made good progress, but is now in a stable phase, in which there is no further
improvement of the complaints. At this stage, the Backstretcher was added to the existing regime.
During the 8-week study, no additional effectiveness of the Backstretcher was observed.
Conclusion of this study is that the Backstretcher is not effective when an irreversible immobility of
the spine has occurred.
Incidentally, HELPmedical knows of casuistic experiences where the Backstretcher was successful in
Bechterew’s disease, but these positive experiences have only been observed in patients who are in
an early stage of the disease.
5. Relaxation9,10
It has been suggested from different sides that the Backstretcher should be able to play a part in
relaxing and fighting stress. In the first place, the Backstretcher is used intensively for this purpose
in Japan. In the second place, HELPmedical regularly receives feedback from users about the
“relaxing effects”.
Furthermore, 9 out of 28 participants in the study (P. Verweij) who suffered from moderate chronic
back complaints, spontaneously mentioned this relaxing effect. Finally, HELPmedical is frequently
approached by Yoga therapists with the question whether the Backstretcher would be useful in
their field.
These suggestions concerning the possible relaxing effect have led to two studies, the first in a
“cool-down” situation after taking part in an intensive aerobics lesson, the second in a yoga
environment, on the one hand to prepare for a meditation session, on the other hand after a yoga
session.
The results underline the relaxing effect of the Backstretcher which has been suggested, as
illustrated by the following data (Backstretcher abbreviated to BS):
Cool-down study
| Context | Condition | Results |
|---|---|---|
| Cool-down (n=147) | Lying on BS for 15 minutes after aerobics lesson | 59% enjoy cool-down on BS (very much) 77% find BS (very) relaxing |
Yoga study – after session
| Context | Condition | Results |
|---|---|---|
| Yoga (n=60) | Lying on BS for 15 minutes after yoga lesson | 85% prefer BS to lying on the ground 75% consider BS to add to the yoga lesson 100% of people with back complaints report spontaneous improvement of complaints |
Yoga study – before meditation
| Context | Condition | Results |
|---|---|---|
| Zen meditation (n=60) | Lying on BS for 10 minutes prior to meditation | 100% find lying on BS a good preparation for meditation 100% report that the meditation position is easier to assume and to maintain; this was also observed by the yoga teacher |
Conclusion from these studies is that lying on the Backstretcher has a relaxing effect on most users.
Wat zeggen onderzoeken over het gebruik van de Backstretcher?
Uit meerdere praktijkgerichte onderzoeken en pilots blijkt dat de Backstretcher een duidelijk positieve werking heeft bij een brede groep mensen met niet-specifieke rugklachten, variërend van mild tot chronisch ernstig. De kern van deze effectiviteit ligt in het antikyphotische en spierontspannende effect, waarmee belangrijke oorzaken van rugpijn direct worden aangepakt.
Bij chronisch ernstige rugklachten liet een pilotstudie zien dat na slechts twee weken dagelijks gebruik al bij 11 van de 12 patiënten sprake was van duidelijke verbetering, waarbij een deel zelfs volledig klachtenvrij werd. Ook op langere termijn bleven de effecten behouden, zonder terugval.
Bij chronisch matige rugklachten bevestigde een grotere studie deze resultaten: ongeveer 90% van de deelnemers ervoer een relevante vermindering van klachten. Daarbij bleek niet alleen pijn te verminderen, maar ook het functioneel herstel groot te zijn. Meer dan 80% van de deelnemers die vooraf beperkt waren in hun werk, was na afloop van het onderzoek weer volledig inzetbaar.
Aanvullend onderzoek toont aan dat de Backstretcher ook een duidelijk ontspannend effect heeft. In sport-, yoga- en meditatiesituaties werd een sterke toename van ontspanning, comfort en voorbereiding op herstel waargenomen. Gebruikers geven consequent aan dat liggen op de Backstretcher ontspanning bevordert en herstel ondersteunt.
Bij vergevorderde Bechterew (ankyloserende spondylitis) bleek de Backstretcher geen extra effect te hebben wanneer er sprake is van onomkeerbare verstijving van de wervelkolom. Wel zijn er positieve ervaringen bij patiënten in een vroeg stadium van deze aandoening, wat het belang van tijdige interventie onderstreept.
Samenvattend laten de onderzoeken zien dat de Backstretcher een effectieve, laagdrempelige en passieve therapievorm is die bij regelmatig gebruik langdurige voordelen kan bieden op het gebied van pijnvermindering, functionaliteit, ontspanning en werkvermogen.