The effectiveness of the McKenzie method in treating lumbar discopathy
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University School of Physical Education in Wrocław, Wrocław, Poland
Physiotherapist; Manus, Długołęka, Poland
Submission date: 2020-01-22
Acceptance date: 2020-10-04
Publication date: 2021-06-10
Hum Mov. 2021;22(4):98-104
The aim of this study was to evaluate the effectiveness of a 2-week physiotherapy treatment augmented with the McKenzie method in patients with lumbar discopathy. The influence of this treatment on progression in the mobility range of lumbar spine was investigated.

Sixty patients aged 40–59 years diagnosed with lumbar discopathy were equally divided into group A (mean age: 51.4 years) and group B (mean age: 51.8 years). The McKenzie method was applied in group A and conservative physiotherapeutic treatment was administered to group B. Pre- and post-intervention measures of spinal range of motion were assessed with a Saunders digital inclinometer; pain intensity and nerve root irritation were also collected. The results were compared between groups.

Spinal mobility improved and pain was reduced in both groups albeit enhanced treatment outcomes were observed in group A compared with group B (p < 0.0001).

The improved response in group A attests to the applicability of the McKenzie method in the treatment of lumbar discopathy. Post-treatment values did not meet clinical norms and may be a result of group characteristics at baseline (high pain level and impeded spinal mobility) or the limited intervention duration.

Last AR, Hulbert K. Chronic low back pain: evaluation and management. Am Fam Physician. 2009;79(12):1067–1074; doi: 10.1080/20786204.2010.10873969.
May S, Donelson R. Evidence-informed management of chronic low back pain with the McKenzie method. Spine J. 2008;8(1):134–141; doi: 10.1016/j.spinee.2007.10.017.
Sipko T, Chantsoulis M, Kuczyński M. Postural control in patients with lumbar disc herniation in the early postoperative period. Eur Spine J. 2010;19(3):409–414; doi: 10.1007/s00586-009-1082-x.
Hawrylak A, Skolimowski T, Barczyk K, Wójtowicz D. The mobility of the lumbar spine in persons with low back pain. Fizjoter Pol. 2004;4(2):100–106.
McKenzie R, May S. The lumbar spine: mechanical diagnosis & therapy. Waikanae: Spinal Publications; 2003.
Adams MA, Mannion AF, Dolan P. Personal risk factors for first-time low back pain. Spine. 1999;24(23):2497–2505; doi: 10.1097/00007632-199912010-00012.
Al-Obaidi SM, Al-Sayegh NA, Nakhi HB, Al-Mandeel M. Evaluation of the McKenzie intervention for chronić low back pain by using selected physical and bio-behavioral outcome measures. PM R. 2011;3(7):637–646; doi: 10.1016/j.pmrj.2011.04.025.
Hauggaard A, Persson AL. Specific spinal stabilisation exercises in patients with low back pain – a systematic review. Phys Ther Rev. 2007;12(3):233–248; doi: 10.1179/108331907X222949.
Rasmussen-Barr E, Ang B, Arvidsson I, Nilsson-Wikmar L. Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month follow-ups. Spine. 2009;34(3):221–228; doi: 10.1097/BRS.0b013e318191e7cb.
Olczak A, Janiszewski M. The importance of the method of McKenzie in classifying and diagnosing lumbar spine pain syndromes. Med Man. 2002;3(4):26–29.
Kilpikoski S, Airaksinen O, Kankaanpää M, Leminen P, Videman T, Alen M. Interexaminer reliability of low back pain assessment using the McKenzie method. Spine. 2002;27(8):E207–E214; doi: 10.1097/00007632-200204150-00016.
Clare HA, Adams R, Maher CG. A systematic review of efficacy of McKenzie therapy for spinal pain. Aust J Physiother. 2004;50(4):209–216; doi: 10.1016/s0004-9514(14)60110-0.
Ratajczak B, Hawrylak A, Demidaś A, Kuciel-Lewandowska J, Boerner E. Effectiveness of diadynamic currents and transcutaneous electrical nerve stimulation in disc disease lumbar part of spine. J Back Musculoskelet Rehabil. 2011;24(3):155–159; doi: 10.3233/BMR-2011-0289.
Ratajczak B, Ryfa R, Boerner E, Kuciel-Lewandowska J, Hawrylak A, Demidaś A. Assessment the influence of the lasertherapy and magnetotherapy in connection with kinesitherapy used by patients with the degenerative low back disease [in Polish]. Adv Rehab. 2011;25(2):13–18; doi: 10.2478/rehab-2013-0005.
Melzack R. From the gate to the neuromatrix. Pain. 1999;Suppl 6:S121–S126; doi: 10.1016/S0304-3959(99)00145-1.
Saunders HD. Saunders digital inclinometer. Chaska: Saunders Group Inc.; 1998.
American Medical Association. AMA guides to the evaluation of permanent impairment, 4th ed. Chicago: AMA; 1993.
Hawrylak A, Chromik K, Ratajczak B, Barczyk-Pawelec K, Demczuk-Włodarczyk E. Spinal range of motion and plantar pressure in sport climbers. Acta Bioeng Biomech. 2017;19(2):169–173; doi: 10.5277/ABB-00647-2016-01.
Czaprowski D, Pawłowska P, Gębicka A, Sitarski D, Kotwicki T. Intra- and interobserver repeatability of the assessment of anteroposterior curvatures of the spine using Saunders digital inclinometer. Ortop Traumatol Rehabil. 2012;14(2):145–153; doi: 10.5604/15093492.992283.
Price DD, McGrath PA, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45–56; doi: 10.1016/0304-3959(83)90126-4.
Capra F, Vanti C, Donati R, Tombetti S, O’Reilly C, Pillastrini P. Validity of the straight-leg raise test for patients with sciatic pain with or without lumbar pain using magnetic resonance imaging results as a reference standard. J Manipulative Physiol Ther. 2011;34(4):231–238; doi: 10.1016/j.jmpt.2011.04.010.
Majlesi J, Togay H, Unalan H, Toprak S. The sensitivity and specificity of the Slump and the Straight Leg Raising tests in patients with lumbar disc herniation. J Clin Rheumatol. 2008;14(2):87–91; doi: 10.1097/RHU.0b013e31816b2f99.
Chou R, Huffman LH, American Pain Society, American College of Physicians. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society. American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147(7):492–504; doi: 10.7326/0003-4819-147-7-200710020-00007.
Slade SC, Keating JL. Measurement of participant experience and satisfaction of exercise programs for low back pain: a structured literature review. Pain Med. 2010;11(10):1489–1499; doi: 10.1111/j.1526-4637.2010.00951.x.
Petersen T, Larsen K, Nordsteen J, Olsen S, Fournier G, Jacobsen S. The McKenzie method compared with manipulation when used adjunctive to information and advice in low back pain patients presenting with centralization or peripheralization: a randomized controlled trial. Spine. 2011;36(24):1999–2010; doi: 10.1097/BR S.0b013e318201ee8e.
Lam OT, Strenger DM, Chan-Fee M, Pham PT, Preuss RA, Robbins SM. Effectiveness of the McKenzie method of mechanical diagnosis and therapy for treating low back pain: literature review with meta-analysis. J Orthop Sports Phys Ther. 2018;48(6):476–490; doi: 10.2519/jospt.2018.7562.
Namnaqani FI, Mashabi AS, Yaseen KM, Alshehri MA. The effectiveness of McKenzie method compared to manual therapy for treating chronic low back pain: a systematic review. J Musculoskelet Neuronal Interact. 2019;19(4):492–499.
Szulc P, Wendt M, Waszak M, Tomczak M, Cieślik K, Trzaska T. 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. Med Sci Monit. 2015;21:2918–2932; doi: 10.12659/MSM.894261.
Garcia AN, Menezes Costa LC, Mota da Silva T, Barreto Gondo FL, Cyrillo FN, Costa RA, et al. Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Phys Ther. 2013;93(6):729–747; doi: 10.2522/ptj.20120414.
Halliday MH, Pappas E, Hancock MJ, Clare HA, Pinto RZ, Robertson G, et al. A randomized controlled trial comparing the McKenzie method to motor control exercises in people with chronic low back pain and a directional preference. J Orthop Sports Phys Ther. 2016;46(7):514–522; doi: 10.2519/jospt.2016.6379.
Rajfur J, Pasternok M, Rajfur K, Walewicz K, Fras B, Bolach B, et al. Efficacy of selected electrical therapies on chronic low back pain: a comparative clinical pilot study. Med Sci Monit. 2017;23:85–100; doi: 10.12659/msm.899461.
De Almeida CC, da Silva VZM, Cipriano G Júnior, Liebano RE, Durigan JLQ. Transcutaneous electrical nerve stimulation and interferential current demonstrate similar effects in relieving acute and chronic pain: a systematic review with meta-analysis. Braz J Phys Ther. 2018;22(5):347–354; doi: 10.1016/j.bjpt.2017.12.005.
Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J. 2004;4(3):335–356; doi: 10.1016/j.spinee.2003.06.002.
Slade SC, Keating JL. Unloaded movement facilitation exercise compared to no exercise or alternative Therapy on outcomes for people with nonspecific chronic low back pain: a systematic review. J Manipulative Physiol Ther. 2007;30(4):301–311; doi: 10.1016/j.jmpt.2007.03.010.
Saur PM, Ensink FB, Frese K, Seeger D, Hildebrandt J. Lumbar range of motion: reliability and validity of the inclinometer technique in the clinical measurement of trunk flexibility. Spine. 1996;21(11):1332–1338; doi: 10.1097/00007632-199606010-00011.
Broetz D, Hahn U, Maschke E, Wick W, Kueker W, Weller M. Lumbar disk prolapse: response to mechanical physiotherapy in the absence of changes in magnetic resonance imaging. Report of 11 cases. NeuroRehabilitation. 2008;23(3):289–294; doi: 10.3233/NRE-2008-23312.
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