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Randomized Controlled Trial
. 2015 Sep 29:21:2918-32.
doi: 10.12659/MSM.894261.

Impact of McKenzie Method Therapy Enriched by Muscular Energy Techniques on Subjective and Objective Parameters Related to Spine Function in Patients with Chronic Low Back Pain

Paweł Szulc  1 , Michał Wendt  2 , Małgorzata Waszak  1 , Maciej Tomczak  3 , Krystyna Cieślik  1 , Tadeusz Trzaska  2
Affiliations
Randomized Controlled Trial

Impact of McKenzie Method Therapy Enriched by Muscular Energy Techniques on Subjective and Objective Parameters Related to Spine Function in Patients with Chronic Low Back Pain

Paweł Szulc et al. Med Sci Monit. .

Abstract

Background: The high incidence and inconsistencies in diagnostic and therapeutic process of low back pain (LBP) stimulate the continuing search for more efficient treatment modalities. Integration of the information obtained with various therapeutic methods and a holistic approach to the patient seem to be associated with positive outcomes. The aim of this study was to analyze the efficacy of combined treatment with McKenzie method and Muscle Energy Technique (MET), and to compare it with the outcomes of treatment with McKenzie method or standard physiotherapy in specific chronic lumbar pain.

Material and methods: The study included 60 men and women with LBP (mean age 44 years). The patients were randomly assigned to 1 of 3 therapeutic groups, which were further treated with: 1) McKenzie method and MET, 2) McKenzie method alone, or 3) standard physiotherapy for 10 days. The extent of spinal movements (electrogoniometry), level of experienced pain (Visual Analogue Scale and Revised Oswestry Pain Questionnaire), and structure of the spinal discs (MRI) were examined prior to the intervention, immediately thereafter, and 3 months after the intervention.

Results: McKenzie method enriched with MET had the best therapeutic outcomes. The mobility of cervical, thoracic, and lumbar spine normalized at levels corresponding to 87.1%, 66.7%, and 95% of respective average normative values. Implementation of McKenzie method, both alone and combined with MET, was associated with a significant decrease in Oswestry Disability Index, significant alleviation of pain (VAS), and significantly reduced size of spinal disc herniation.

Conclusions: The combined method can be effectively used in the treatment of chronic LBP.

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Figures

Figure 1
Figure 1
Mean angular values of the anterior flexion of the cervical spine determined at various phases of the study in patients treated with three different therapeutic methods (McKenzie method + MET, McKenzie method alone, standard physiotherapy).
Figure 2
Figure 2
Mean angular values of the anterior flexion of the thoracic spine determined at various phases of the study in patients treated with three different therapeutic methods (McKenzie method + MET, McKenzie method alone, standard physiotherapy).
Figure 3
Figure 3
Mean angular values of the anterior flexion of the lumbar spine determined at various phases of the study in patients treated with three different therapeutic methods (McKenzie method + MET, McKenzie method alone, standard physiotherapy).
Figure 4
Figure 4
Functional parameters of the cervical spine (CL – cervical lordosis; CAF – cervical anterior flexion; CPF – cervical posterior flexion; CRF – cervical right flexion; CLF – cervical left flexion; CRR – cervical right rotation; CLR – cervical left rotation) – comparison between values determined in patients treated with three different therapeutic methods and respective normative values published by Lewandowski.
Figure 5
Figure 5
Functional parameters of the thoracic spine (ThK – thoracic kyphosis; ThAF – thoracic anterior flexion; ThPF – thoracic posterior flexion; ThRF – thoracic right flexion; ThLF – thoracic left flexion; ThRR – thoracic right rotation; ThLR – thoracic left rotation) – comparison between values determined in patients treated with three different therapeutic methods and respective normative values published by Lewandowski.
Figure 6
Figure 6
Functional parameters of the lumbar spine (LL – lumbar lordosis; LAF – lumbar anterior flexion; LPF – lumbar posterior flexion; LRF – lumbar right flexion; LLF – lumbar left flexion; LRR – lumbar right rotation; LLR – lumbar left rotation) – comparison between values determined in patients treated with three different therapeutic methods and respective normative values published by Lewandowski.
Figure 7
Figure 7
Magnetic resonance images of the structural changes of the L5–S1 spinal disc: (A) prior to, and (B) after the combined therapy (McKenzie method + MET).
See this image and copyright information in PMC

References

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