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The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain - A randomized controlled trial

Petersen, Tom LU ; Kryger, P; Ekdahl, Charlotte LU ; Olsen, S and Jacobsen, S (2002) In Spine 27(16). p.1702-1708
Abstract
Study Design. A randomized controlled comparative trial with an 8-month follow-up period was conducted. Objective. To compare the effect of the McKenzie treatment method with that of intensive dynamic strengthening training in patients with subacute of chronic low back pain. Summary of Backround Data. Randomized studies indicate that the efficacy of the McKenzie method in the treatment of patients with acute or subacute low back-pain is debatable. Currently, no randomized studies examining the effects of this method for patients with chronic low back pain have been published. Methods. For this study, 260 consecutive patients with low back pain and at least 8 weeks duration of symptons (85% of the patients had more than 3 months duration of... (More)
Study Design. A randomized controlled comparative trial with an 8-month follow-up period was conducted. Objective. To compare the effect of the McKenzie treatment method with that of intensive dynamic strengthening training in patients with subacute of chronic low back pain. Summary of Backround Data. Randomized studies indicate that the efficacy of the McKenzie method in the treatment of patients with acute or subacute low back-pain is debatable. Currently, no randomized studies examining the effects of this method for patients with chronic low back pain have been published. Methods. For this study, 260 consecutive patients with low back pain and at least 8 weeks duration of symptons (85% of the patients had more than 3 months duration of symptoms) were randomized into two groups: Group A was treated with the McKenzie method (n = 132), and Group B was treated with intensive dynamic strengthening training (n = 128). The treatment period for both groups was 8 weeks at an outpatient clinic, followed by 2 months of self-training at home. Treatment results were recorded at the end of the treatment period at the clinic, then 2 and 8 months after. In both groups, 30% of the patients were lost to follow-up evaluation. An intention-to-treat analysis of the main effect variables, disability, and pain was perfromed for all the patients included in the study. A supplementaty analysis of the 180 patients who completed the full treatment program also was undertaken. Results. Intention-to-treat analysis showed a tendency toward a difference in reduction of disability in favor of the McKenzie group at the 2-month follow-up assessment (P = 0.04), but no differences at the end of treatment and at the 8-month follow-up evaluation. No differences in reduction of pain were observed at any time between the groups. The supplementary analysis of the patients who had completed the full intervention showed a tendency toward a difference in favour of the McKenzie method in reduction of pain at the end of treatment (P = 0.02). This difference reached statistical significance at the 2-month follow-up assessment (P= 0.01), but no difference was found after 8 months. The supplementary analysis showed no differences between the groups with regard to reduction of disability. Conclusion. The McKenzie method and intensive dynamic strengthening training seem to be equally effective in the treatment of patients with subacute or chronic low back pain. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
physical training, physical therapy, McKenzie treatment, low back pain, chronic diseases, exercises, randomized controlled trial
in
Spine
volume
27
issue
16
pages
1702 - 1708
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000177515700004
  • pmid:12195058
  • scopus:0037102565
ISSN
0362-2436
DOI
10.1097/01.BRS.0000020047.74007.AB
language
English
LU publication?
yes
id
baea579c-a5b8-4d0b-8275-86df6cdb0e27 (old id 330232)
alternative location
http://www.spinejournal.com/pt/re/spine/abstract.00007632-200208150-00004.htm
date added to LUP
2007-11-08 14:42:30
date last changed
2017-12-10 03:38:17
@article{baea579c-a5b8-4d0b-8275-86df6cdb0e27,
  abstract     = {Study Design. A randomized controlled comparative trial with an 8-month follow-up period was conducted. Objective. To compare the effect of the McKenzie treatment method with that of intensive dynamic strengthening training in patients with subacute of chronic low back pain. Summary of Backround Data. Randomized studies indicate that the efficacy of the McKenzie method in the treatment of patients with acute or subacute low back-pain is debatable. Currently, no randomized studies examining the effects of this method for patients with chronic low back pain have been published. Methods. For this study, 260 consecutive patients with low back pain and at least 8 weeks duration of symptons (85% of the patients had more than 3 months duration of symptoms) were randomized into two groups: Group A was treated with the McKenzie method (n = 132), and Group B was treated with intensive dynamic strengthening training (n = 128). The treatment period for both groups was 8 weeks at an outpatient clinic, followed by 2 months of self-training at home. Treatment results were recorded at the end of the treatment period at the clinic, then 2 and 8 months after. In both groups, 30% of the patients were lost to follow-up evaluation. An intention-to-treat analysis of the main effect variables, disability, and pain was perfromed for all the patients included in the study. A supplementaty analysis of the 180 patients who completed the full treatment program also was undertaken. Results. Intention-to-treat analysis showed a tendency toward a difference in reduction of disability in favor of the McKenzie group at the 2-month follow-up assessment (P = 0.04), but no differences at the end of treatment and at the 8-month follow-up evaluation. No differences in reduction of pain were observed at any time between the groups. The supplementary analysis of the patients who had completed the full intervention showed a tendency toward a difference in favour of the McKenzie method in reduction of pain at the end of treatment (P = 0.02). This difference reached statistical significance at the 2-month follow-up assessment (P= 0.01), but no difference was found after 8 months. The supplementary analysis showed no differences between the groups with regard to reduction of disability. Conclusion. The McKenzie method and intensive dynamic strengthening training seem to be equally effective in the treatment of patients with subacute or chronic low back pain.},
  author       = {Petersen, Tom and Kryger, P and Ekdahl, Charlotte and Olsen, S and Jacobsen, S},
  issn         = {0362-2436},
  keyword      = {physical training,physical therapy,McKenzie treatment,low back pain,chronic diseases,exercises,randomized controlled trial},
  language     = {eng},
  number       = {16},
  pages        = {1702--1708},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Spine},
  title        = {The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain - A randomized controlled trial},
  url          = {http://dx.doi.org/10.1097/01.BRS.0000020047.74007.AB},
  volume       = {27},
  year         = {2002},
}