The McKenzie method for treating low back pain
Altogether, this review shows McKenzie’s Mechanical Diagnosis and Therapy (MDT) method is not superior to a combined exercise and manual therapy approach for pain and disability in acute (
On the other hand, MDT showed greater effectiveness for the management of pain and disability in chronic (>12 weeks) LBP.
However, effect sizes were small to moderate and depending on the treatment being compared to MDT. Thus, a definite conclusion on the clinical significance of these diferences is still not possible.
LBP continues to be the world's leading cause of increased years living with disability.
There is a recent trend to move away from a pathoanatomical model of LBP, and classification-based systems have been gaining in popularity. However, definite evidence of the effectiveness of MDT has not been established yet.
11 RCTs of moderate to high quality were analysed. Study quality was assessed using the PEDro scale. The effectiveness of MDT compared with manual therapy, exercise, or a combination of both was tested.
MDT was not found to be superior to any of the isolated or combined approaches in acute LBP.
In chronic LBP, MDT was found superior to isolated but not to combined interventions.
These differences may be related to the distinct psychosocial and physiological factors of acute and chronic LBP.
> From: Lam et al., J Orthop Sports Phys Ther 48 (2018) 476-490 (Epub ahead of print). All rights reserved to Journal of Orthopedic & Sports Physical Therapy. Click here for the online summary.