Williams Flexion Exercise for Low Back Pain: A Possible Implementation in Rural Areas

  • William Sukmajaya Department of Orthopedics and Traumatology, Saiful Anwar General Hospital-Universitas Brawijaya, Malang, East Java, Indonesia
  • Firas Farisi Alkaff Department of Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
  • Alina Oen Department of Rehabilitation and Physical Medicine, Surabaya Orthopedics and Traumatology Hospital, Surabaya, East Java, Indonesia
  • Alverina Cynthia Sukmajaya Department of Biomedical Science, Faculty of Medicine, Airlangga University, Surabaya, East Java, Indonesia
Keywords: Chronic pain, Disability evaluation, Exercise therapy, Low back pain, Rural population


AIM: Low back pain (LBP) is a widespread complaint of all age groups. The economic burden of LBP is high, and physiotherapy has proven to reduce this. Unfortunately, physiotherapy or exercise regimen is rarely prescribed to LBP patients by doctors. Until now, there was no study regarding the application of physiotherapy exercise in Indonesia. This study aims to evaluate the effect of Williams flexion exercise (WFE) toward people with LBP.

METHODS: This was a pretest-posttest experimental study design of PROLANIS participants with LBP complaints in one of the primary health-care centers in Jombang, East Java, Indonesia, on June 2018–July 2018. The total sampling method was used in this study. Participants’ basic clinical data and Oswestry Disability Index (ODI) were obtained through a self-administered questionnaire. WFE was taught to the participants through a presentation, video, and live demonstration. After 1 month, ODI of the participants was reassessed.

RESULTS: There were 42 participants included in this study. There was a significant ODI difference between pre- and post-WFE implementation (31.05 ± 17.40 vs. 14.10 ± 11.78, p = 0.019). Higher exercise frequency (>1 times/day) was associated with further reduction in ODI compared to lower exercise frequency group (1 time/day) (22.09 ± 19.09 vs. 7.38 ± 12.58, p = 0.017). There was no significant difference in ODI reduction between geriatric and non-geriatric participants (p = 0.24).

CONCLUSION: WFE improves functional symptoms of LBP regardless of age. This exercise could be implemented in a primary health-care setting in future to reduce the cost for LBP treatment.


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How to Cite
Sukmajaya W, Alkaff FF, Oen A, Sukmajaya AC. Williams Flexion Exercise for Low Back Pain: A Possible Implementation in Rural Areas. Open Access Maced J Med Sci [Internet]. 2020Feb.5 [cited 2020Oct.23];8(B):1-. Available from: https://www.id-press.eu/mjms/article/view/3988