The effects of McKenzie exercises for patients with low back pain, our experience

Abstract

OBJECTIVE:To investigate influence of McKenzie exercises on decreasing the pain in patients with low back pain, to show occurrence of Centralization sign, as a predictor of good treatment outcomes and to evaluate use of McKenzie exercises, as a routine method for lower back pain in Physical Medicine and Rehabilitation Centres.DESIGN:Clinical, prospective, manipulative study.SETTING:Physiotherapy and Rehabilitation Clinic in Community Based Rehabilitation Centers and Institute for Physical Medicine and Rehabilitation affiliated with a Medical College Sarajevo.PARTICIPANTS:Thirty-four patients with symptoms of low back pain.INTERVENTIONS:McKenzie exercise program for low back pain were performed individually to the need and possibility of each patient. Patients attended exercise program daily, under supervision of physiatrist and physiotherapist and do it also at home, five times a day in series of 5 to 10 repetition each time, depending of stage of disease and pain intensity. The average training period was 15,5 days.MAIN OUTCOME MEASURES:All patients were assessed before and after the treatment. Visual Analog Scale (VAS) measured intensity of pain, localization of pain was noted on special forms and Shober test was used to show differences in spinal movement before and after the treatment.RESULTS:Measurements of spinal movements and flexibility of spine showed significant improvement in all patients. Average difference in values of Shober test before and after treatment was 1,1 cm with SD 0,98. Difference test was t=6,263 with significant difference p<0,01. Mean pain intensity was reduced significantly as a result of treatment. Pain was reduced on VAS for X=2,8 with S.D. 1,56. Difference Test was t=10,332, with significant difference p<0.01. 61,5% of total number of participants had signs of centralisation (6% were in acute stage of pain, 32% in subacute and 23,5% in chronic pain). Centralisation sign was noted in 40% of acute patients, 57.5% subacute and 80% of chronic patients with a low back pain who exercised McKenzieprogram.CONCLUSIONS:McKenzie exercises for low back pain are beneficial treatment for increasing flexibility of spine and improving the pain with better results in pain relief. Although done by minimally trained physiotherapists in McKenzie approach, McKenzieexercises are successful method for decreasing and centralising the pain and increasing spinal movements in patients with lowback pain.