Comparative Effects of McGill and McKenzie Exercises in Low Back Pain

February 4, 2026 updated by: Riphah International University

Comparative Effects of McGill and McKenzie Exercises on Pain, Range of Motion and Disability in Patients With Chronic Mechanical Low Back Pain

The study was conducted to determine the comparative effects of McGill and McKenzie exercises on pain, range of motion and disability in patients with chronic mechanical low back pain.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
57

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan
        • Naseer Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Both genders.
  • Patients between 20-40 years.
  • At least 6 months of history of chronic mechanical low back pain.
  • Negative Lasegue's Test.
  • Negative Slump Test.
  • Patient presenting with NPRS values of above 1 and equal to or less than 6.
  • ODI score from 5-24, with the patient showing minimal to moderate disability.
  • Patient showing restricted lumbar range of motion in any direction of flexion, extension, and lateral flexion.
  • Participants must demonstrate an extension directional preference during clinical examination (For the safety purpose of the patients)

Exclusion Criteria:

  • Lumbar radiculopathy.

    • Previous record showing Trauma or accident.
    • Any previous surgical record of Lumbar Spine Surgery.
    • Acute or Subacute low back pain.
    • History of spinal osteoporosis.
    • Vertebral Fractures.
    • Tumors and active infections.
    • Diagnosed psychological disorders.
    • Any spinal deformity
    • Participants who do not show directional preference towards extension

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: McGill Exercises
Other: McGill Exercises

McGill Big three exercises for 10 repetitions and 5-10 seconds of hold initially. Progression was tailored as per the patient's requirements and stamina.

  • Standardized physiotherapy treatment at the first session.
  • McGill curl-up
  • Isometric horizontal side support, either with support on knees or on foot, according to patient stamina.
  • Single leg extension holds on hands and knees, also known as McGill Birddog, either with or without raising the contralateral arm as per patient stamina.
Other: Standardized Physiotherapy Treatment
  • Electrical Heating Pad was applied for 10 minutes.
  • TENS was applied (low frequency) for 10 minutes.
  • Posterior to Anterior Glides of Lumbar Spine in Maitland Grade-III, with 4 sets and 4 repetitions each. The patient will be in a prone position.
Active Comparator: McKenzie Exercises
Other: Standardized Physiotherapy Treatment
  • Electrical Heating Pad was applied for 10 minutes.
  • TENS was applied (low frequency) for 10 minutes.
  • Posterior to Anterior Glides of Lumbar Spine in Maitland Grade-III, with 4 sets and 4 repetitions each. The patient will be in a prone position.
Other: McKenzie Exercises

McKenzie extension exercise plan (EEP) for 10 repetitions and 5-10 seconds of hold initially. Progression was tailored as per the patient's requirements and symptoms

  • Standardized physiotherapy treatment at the first session.
  • Lying face down in extension on elbows.
  • Full press up.
  • Extension in standing.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale
Time Frame: From enrollment to the end of the treatment at 6 weeks
Pain intensity was measured using the Numeric Pain Rating Scale which is abbreviated as NPRS. In this tool, individuals score their pain levels on a scale from 0 to 10. When a participant selects 0, it means they had no pain. On the other hand, if it is 10, the participant must be going through the worst pain imaginable.
From enrollment to the end of the treatment at 6 weeks
Oswestry Disability Index
Time Frame: From enrollment to the end of the treatment at 6 weeks.
The Oswestry Disability Index (ODI) is a questionnaire that participants fill themselves based on self-reporting. It is based on disability caused by low back pain. Pynsent in Oswestry, England, introduced it in 1980. It has become one of the most widely used and trusted tools for evaluating disability related to back pain.
From enrollment to the end of the treatment at 6 weeks.
Lumbar Range of Motion
Time Frame: From enrollment to the end of the 6 weeks
Different instruments are used in physiotherapy to measure the range of motions, like a goniometer and an inclinometer. An inclinometer is used to measure spinal ROM.
From enrollment to the end of the 6 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Lumbar Flexion
Time Frame: From enrollment to end of the treatment at 6 weeks.
Measured by inclinometer.
From enrollment to end of the treatment at 6 weeks.
Lumbar Extension
Time Frame: From enrollment to end of the treatment by 6 weeks.
Measured by Inclinometer
From enrollment to end of the treatment by 6 weeks.
Lumbar Right Lateral Flexion
Time Frame: From enrollment to the end of 6 weeks
Measured by Inclinometer
From enrollment to the end of 6 weeks
Lumbar Left Lateral Flexion
Time Frame: From enrollment to end of the treatment by 6 weeks.
Measured by using Inclinometer
From enrollment to end of the treatment by 6 weeks.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Shakil ur Rehman, Ph.D, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Will JS, Bury DC, Miller JA. Mechanical Low Back Pain. Am Fam Physician. 2018 Oct 1;98(7):421-428.
  • Waqqar S, Shakil-Ur-Rehman S, Ahmad S. McKenzie treatment versus mulligan sustained natural apophyseal glides for chronic mechanical low back pain. Pak J Med Sci. 2016 Mar-Apr;32(2):476-9. doi: 10.12669/pjms.322.9127.
  • Ghorbanpour A, Azghani MR, Taghipour M, Salahzadeh Z, Ghaderi F, Oskouei AE. Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability and active back range of motion in patients with chronic non-specific low back pain. J Phys Ther Sci. 2018 Apr;30(4):481-485. doi: 10.1589/jpts.30.481. Epub 2018 Apr 13.
  • Sabourin S, Tram J, Sheldon BL, Pilitsis JG. Defining minimal clinically important differences in pain and disability outcomes of patients with chronic pain treated with spinal cord stimulation. Journal of Neurosurgery: Spine. 2021;35(2):243-50.
  • Young I, Dunning J, Escaloni J, Maselli F, Prall J, Mourad F, et al. Reliability, construct validity, responsiveness and minimum clinically important difference of the numeric pain rating scale and shoulder pain and disability index in patients with subacromial pain syndrome. Musculoskeletal Science and Practice. 2025:103372.
  • na Fisioterapia MM. Methods & protocols.
  • McGill SM. Low Back Exercises: Evidence for Improving Exercise Regimens. Physical Therapy. 1998;78(7):754-65.
  • Saur PM, Ensink F-BM, 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):1332-8.
  • Grotle M, Brox JI, Vøllestad NK. Cross-cultural adaptation of the Norwegian versions of the Roland-Morris Disability Questionnaire and the Oswestry Disability Index. Journal of rehabilitation medicine. 2003;35(5):241-7.
  • JD C. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine. 2005;30:686-96.
  • Alhakami AM, Davis S, Qasheesh M, Shaphe A, Chahal A. Effects of McKenzie and stabilization exercises in reducing pain intensity and functional disability in individuals with nonspecific chronic low back pain: a systematic review. Journal of physical therapy science. 2019;31(7):590-7.
  • Nayyab I, Ghous M, Shakil Ur Rehman S, Yaqoob I. The effects of an exercise programme for core muscle strengthening in patients with low back pain after Caesarian-section: A single blind randomized controlled trial. J Pak Med Assoc. 2021;71(5):1319-25.
  • Ahmed R, Shakil-ur-Rehman S, Sibtain F. Comparison between specific lumber mobilization and core-stability exercises with core-stability exercises alone in mechanical low back pain. Pakistan journal of medical sciences. 2014;30(1):157.
  • Golzar J, Noor S, Tajik O. Convenience sampling. International Journal of Education & Language Studies. 2022;1(2):72-7.
  • Javaherian M, Bashardoust TS, ATTARBASHI MB, KESHTKAR A, Azizi M. Immediate effects of Maitland mobilization and Mulligan techniques on flexion and extension range of motion in patients with chronic nonspecific low back pain: a randomized pilot study. 2017.
  • Kleine-Borgmann J, Schmidt K, Hellmann A, Bingel U. Effects of open-label placebo on pain, functional disability, and spine mobility in patients with chronic back pain: a randomized controlled trial. Pain. 2019;160(12):2891-7.
  • Ghasemi G, Goharjoo M, Faizi M. Effects of conventional core stability and core stability suspension exercises on multifidus muscle endurance, pain and quality of life in people with nonspecific chronic low back pain. Jundishapur Scientific Medical Journal. 2020;18(6):571-84.
  • Hernándeza DMG, Pérez SMO, Ardón FB, Núñez CLT, Moreno JGO. Effectiveness of neurodynamic mobilization and MCGILL-type strengthening exercises in patients with piriformis syndrome: study protocol for a randomized controlled trial. Physical Rehabilitation and Recreational Health Technologies. 2024;9(3):188-200.
  • Purushothaman S, Gayathri K, Thiyagarajan A, Vardhini CI, Babu LH, Nainar M. Clinical Evaluation of the McGill Stabilization Exercise Program for Chronic Nonspecific Low Back Pain: Insights from Case Studies. Journal of Society of Indian Physiotherapists. 2024;8(2):144-8.
  • Baghani P, Naserpour N, Piri H. Supervised Group Exercise Therapy Versus Home-based Exercise Therapy: The Effect of McGill Exercises on Pain, Disability and Trunk Stability in Middle-aged Women With Non-specific Chronic Low Back Pain. Physical Treatments-Specific Physical Therapy Journal. 2023;13(2):127-34.
  • Aqil F, Iqbal MA, Karim S, Iqbal MU, Akram MJ, Mehreen Z, et al. Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain. Rehman Journal of Health Sciences. 2021;3(1):24-31.
  • Bose G, Gohill D. Effect of Mckenzie Therapy and Lumbar Strengthening Program in Lumbar Spine Derangement Syndrome 1. European Journal of Pharmaceutical and Medical Research. 2018;5(3):160-4.
  • 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. Journal of musculoskeletal & neuronal interactions. 2019;19(4):492.
  • 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. Journal of orthopaedic & sports physical therapy. 2018;48(6):476-90.
  • Olaoye MI, Okonji R, Ademoyegun A, Gebrye T, Yeowell G, Fatoye F, et al. Biochemical and clinical effects of McKenzie therapy versus muscle endurance exercises in chronic low-back pain. Arch Physiother. 2025;15:229-49.
  • Calatayud J, Escriche-Escuder A, Cruz-Montecinos C, Andersen LL, Pérez-Alenda S, Aiguadé R, et al. Tolerability and muscle activity of core muscle exercises in chronic low-back pain. International journal of environmental research and public health. 2019;16(19):3509.
  • Langevin HM, Sherman KJ. Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms. Medical hypotheses. 2007;68(1):74-80.
  • Casiano VE, Sarwan G, Dydyk AM, Varacallo MA. Back pain. StatPearls [Internet]: StatPearls Publishing; 2023.
  • Mohd Isa IL, Teoh SL, Mohd Nor NH, Mokhtar SA. Discogenic low back pain: anatomy, pathophysiology and treatments of intervertebral disc degeneration. International journal of molecular sciences. 2022;24(1):208.
  • Li W, Gong Y, Liu J, Guo Y, Tang H, Qin S, et al. Peripheral and central pathological mechanisms of chronic low back pain: a narrative review. Journal of pain research. 2021:1483-94.
  • Borenstein D. Mechanical low back pain-a rheumatologist's view. Nature Reviews Rheumatology. 2013;9(11):643-53.
  • Hnatešen D, Pavić R, Radoš I, Dimitrijević I, Budrovac D, Čebohin M, et al. Quality of Life and Mental Distress in Patients with Chronic Low Back Pain: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2022;19(17):10657.
  • Osagie RO, Tufa I, Angarita-Fonseca A, Pagé MG, Lacasse A, Stone LS, et al. Impact of different acute low back pain definitions on the predictors and on the risk of transition to chronic low back pain: a prospective longitudinal cohort study. PAIN. 2025;166(11):e577-e89.
  • Nieminen LK, Pyysalo LM, Kankaanpää MJ. Prognostic factors for pain chronicity in low back pain: a systematic review. Pain reports. 2021;6(1):e919.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
January 13, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 31, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 30, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 4, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 4, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 11, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
February 11, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 4, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REC/RCR & AHS/24/0179

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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