Built on a foundation of science, with effectiveness proved by research studies.

SpineZone was architected and perfected based on greater than 120 peer reviewed articles on Strengthening, Posture, Cognitive Behavioural Therapy, and Back Pain research.

In 2010, the outcomes and costs of SpineZone were comprehensively studied and presented. In 2013, the results were published by SCMG in CAPG, and presented again in 2014 at the International Society for the Study of the Lumbar Spine in Seoul, Korea.

Supporting Literature on Using Exercise to Avoid Surgery

  • Restorative exercise for clinical low back pain. A prospective two-center study with 1-year follow-up. Leggett S, Mooney V, Spine. 1999 May 1;24(9):889-98.
  • The clinical effects of intensive, specific exercise on chronic low back pain: a controlled study of 895 consecutive patients with 1-year follow up. Nelson BW et al. Orthopedics. 1995 Oct;18(10):971-81.
  • A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Bronfort G et al. Spine. 2001 Apr 1;26(7):788-97.
  • Can spinal surgery be prevented by aggressive strengthening exercises? A prospective study of cervical and lumbar patients Nelson BW et al. Arch Phys Med Rehabil. 1999 Jan;80(1):20-5.
  • Low back strengthening for the prevention and treatment of low back pain. Carpenter DM et al. Med Sci Sports Exerc. 1999 Jan;31(1):18-24

Supporting Literature on Back/Neck Pain research

  • Machado LAC, de Souza MvS, Ferreira PH, Ferreira ML, The McKenzie Method for low back pain. A systematic review of the literature with a meta-analysis approach, Spine, 31:E254-E262, 2006
  • Bigos SJ, Holland J, Holland C, Webster JS, Battie M, Malmgren JA, High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults., Spine J, 9:147-168, 2009
  • Choi BKL, Verbeek JH, Tam WWS, Jiang JY, Exercises for prevention of recurrences of low-back pain, Cochrane Library, Issue 3. www.thecochraneibrary.com, 2010
  • Chorti AG, Chortis AG, Strimpakos N, McCarthy CJ, Lamb SE, The prognostic value of symptom responses in the conservative management of spinal pain. A systematic review., Spine, 34:2686-2699, 2009
  • Cook C, Hegedus EJ, Ramey K, Physical therapy exercise intervention based on classification using the patient response method: a systematic review of the literature, J Man & Manip Ther,13:152-162, 2005
  • Crawford C, Lee C, May T et al., Physically oriented therapies for the self-management of chronic pain symptoms., Pain Med, 15:S54-S65, 2014
  • Dunsford A, Kumar S, Clarke S, Integrating evidence into practice: use of McKenzie-based treatment for mechanical low back pain., J Multidisciplinary Healthcare, 4.393-402, 2011
  • Kent P, Mjøsund HL, Petersen D, Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review., BMC Medicine, 8:22,2010
  • Clare HA, Adams R, Maher CG, A systematic review of efficacy of McKenzie therapy for spinal pain., Aust J Physiother, 50(4):209-16, 2004

Supporting Literature on Cognitive Behavioural Therapy

  • Can Chronic Disability Be Prevented?: A Randomized Trial of a Cognitive-Behavior Intervention and Two Forms of Information for Patients With Spinal Pain, Spine, 1 November 2000 - Volume 25 - Issue 21 - pp 2825-2831 Randomized Trial
  • Psychosocial interventions for low back pain in primary care: lessons learned from recent trials.. van der Windt D(1), Hay E, Jellema P, Main C., Spine 2008 Jan 1;33(1):81-9.
  • Treatment expectancy and credibility are associated with the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. Smeets RJ(1), Beelen S, Goossens ME, Schouten EG, Knottnerus JA, Vlaeyen JW. Clin J Pain. 2008 May;24(4):305-15.
  • Predicting response to a cognitive-behavioral approach to treating low back pain: Secondary analysis of the BeST data set. Arthritis Care Res (Hoboken). 2011 Sep;63(9):1271-9.
  • The CONECSI trial: results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury. Pain. 2012 Jan;153(1):120-8.
  • Effectiveness of different interventions using a psychosocial subgroup assignment in chronic neck and back pain patients: a 10-year follow-up. Disabil Rehabil. 2012;34(2):110-8.
  • An online self-help CBT intervention for chronic lower back pain. Carpenter KM(1), Stoner SA, Mundt JM, Stoelb B. Clin J Pain. 2012 Jan;28(1):14-22.
  • A short, intensive cognitive behavioral pain management program reduces health-care use in patients with chronic low back pain: two-year follow-up results of a prospective cohort., van Hooff ML(1), Ter Avest W, Horsting PP, O'Dowd J, de Kleuver M, van Lankveld W, van Limbeek J. Eur Spine J. 2012 Jul;21(7):1257-64. Dec 3.
  • Early coordinated multidisciplinary intervention to prevent sickness absence and labour market exclusion in patients with low back pain: study protocol of a randomized controlled trial. Fisker A(1), Langberg H, Petersen T, Mortensen OS. BMC Musculoskelet Disord. 2013 Mar 13;14:93.
  • Effect of a long-lasting multidisciplinary program on disability and fear-avoidance behaviors in patients with chronic low back pain: results of a randomized controlled trial. Monticone M(1), Ferrante S, Rocca B, Baiardi P, Farra FD, Foti C. Clin J Pain. 2013 Nov;29(11):929-38.
  • A multidisciplinary rehabilitation programme improves disability, kinesiophobia and walking ability in subjects with chronic low back pain: Results of a randomised controlled pilot study. Eur Spine J. 2014 Oct;23(10):2105-13.
  • Patient Engagement—What Works? April/June 2012 - Volume 35 - Issue 2 - p 80–89 Journal of Ambulatory Care Management
  • Improving Chronic Illness Care: Translating Evidence Into Action Edward H. Wagner, Health Affairs
  • A Review and Synthesis of Research Evidence for Self-Efficacy-Enhancing Interventions for Reducing Chronic Disability: Implications for Health Education Practice (Part II), Ray Marks 2005, Health Promotion Practice

Supporting Literature on Posture research

  • Effect of pelvic forward tilt on low back compressive and shear forces during a manual lifting task.Hayashi S, Katsuhira J, Matsudaira K, Maruyama H. J Phys Ther Sci. 2016 Mar;28(3):802-6.
  • Changes in Habitual and Active Sagittal Posture in Children and Adolescents with and without Visual Input - Implications for Diagnostic Analysis of Posture. Ludwig O, Mazet C, Mazet D, Hammes A, Schmitt E. J Clin Diagn Res. 2016 Feb;10(2):SC14-7.
  • Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Waongenngarm P, Rajaratnam BS, Janwantanakul P. Saf Health Work. 2016 Mar;7(1):49-54.
  • Relationships between each part of the spinal curves and upright posture using Multiple stepwise linear regression analysis. Boulet S, Boudot E, Houel N. J Biomech. 2016 May 3;49(7):1149-55.
  • Postural Cueing to Increase Lumbar Lordosis Increases Lumbar Multifidus Activation During Trunk Stabilization Exercises: Electromyographic Assessment Using Intramuscular Electrodes. Beneck GJ, Story JW, Donald S. J Orthop Sports Phys Ther. 2016 Apr;46(4):293-9.
  • Age-related differences on low back pain and postural control during one-leg stance: a case-control study. da Silva RA, Vieira ER, Carvalho CE, Oliveira MR, Amorim CF, Neto EN. Eur Spine J. 2016 Apr;25(4):1251-7.
  • Postural strategy and trunk muscle activation during prolonged standing in chronic low back pain patients. Ringheim I, Austein H, Indahl A, Roeleveld K. Gait Posture. 2015 Oct;42(4):584-9.
  • Effect of an exercise program for posture correction on musculoskeletal pain. Kim D, Cho M, Park Y, Yang Y. J Phys Ther Sci. 2015 Jun;27(6):1791-4.

Supporting Literature on our Strengthening Approach

Our custom equipment reduces chronic spine-related pain issues, restores spinal function, reduces or eliminates the need for ongoing care, and improve patients’ quality of life.

  • Lumbar Strengthening in Chronic Low Back Pain Patients Spine
  • Muscle - In Rehabilitation of the Spine: Science and Practice Orthopedics Today
  • A Preliminary Report on the Effect of Measured Strength Training in Adolescent Idiopathic Scoliosis Journal of Spinal Disorders
  • Changes in Isometric Strength and Range of Motion of the Isolated Cervical Spine After Eight Weeks of Clinical Rehabilitation Spine
  • Comparison of Female Geriatric Lumbar Extension Strength Journal of Spinal Disorders
  • Effect of Focused Strength Training After Low Back Injury North American Spine Society
  • Effect of Reduced Training Frequency and Detraining on Lumbar Extension Strength Spine
  • Effect of Resistance Training on Lumbar Extension Strength The American Journal of Sports Medicine
  • Effect of Training Frequency and Specificity on Isometric Lumbar Extension Strength Spine
  • Low Back Strengthening for the Prevention and Treatment of Low Back Pain Medicine & Science in Sports & Medicine
  • The Role of Measured Resistance Exercises in Adolescent Scoliosis Orthopedics
  • Two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain Spine
  • Effect of Resistance Training Volume on Strength and Muscle Thickness Medicine & Science in Sports & Medicine
  • Effects of Isolated Lumbar Extension Resistance Training on Bone Mineral Density of the Elderly American College of Sports Medicine
  • Effects of Three Different Training Modalities on the Cross Sectional Area of the Lumbar Multifidus British Journal of Sports Medicine
  • Electromyographic Analysis of Four Techniques for Isometric Trunk Muscle Exercises Arch Phys Med Rehabil
  • Frequency and Volume of Resistance Training Arch Phys Med Rehabil
  • Isometric Torso Rotation Strength Arch Phys Med Rehabil
  • Pelvic Stabilization During Resistance Training: Its Effect on the Development of Lumbar Extension Strength Arch Phys Med Rehabil
  • Quantitative Assessment and Training of Isometric Cervical Extension Strength Medicine & Science in Sports & Medicine
  • Quantitative Assessment of Full Range-of-Motion Isometric Lumbar Extension Strength Arch Phys Med Rehabil
  • Strength Testing Can Identify Malingering The Journal of Workers Compensation
  • The Effect of early Isolated Lumbar Extension Exercise Program for Patients with Herniated Disc Undergoing Lumbar Discectomy Neurosurgery
  • A Rational Approach to the Treatment of Low Back Pain The Journal of Musculoskeletal Medicine
  • The Clinical Effects of Intensive, Specific Exercise on Chronic Low-Back Pain: A Controlled Study of 895 Consecutive Patients with One Year Follow-Up Low Back Pain
  • One Lumbar Extension Training Session per Week Is Sufficient for Strength Gains and Reductions in Pain in Patients with Chronic Low Back Pain Ergonomics
  • Specific Spinal Exercise: Three Case Studies Using the MedX Lumbar Extension Machine IART Research