Effects of McKenzie and stabilization exercises in reducing pain intensity and functional disability in individuals with nonspecific chronic low back pain: a systematic review

Anas Mohammed Alhakami, Sally Davis, Mohammed Qasheesh, Abu Shaphe, Aksh Chahal, Anas Mohammed Alhakami, Sally Davis, Mohammed Qasheesh, Abu Shaphe, Aksh Chahal

Abstract

[Purpose] The purpose of this review is to compare the effect of McKenzie and stabilization exercises in reducing pain and disability in individuals with chronic nonspecific low back pain. [Methods] A systematic literature review of randomized controlled trials (RCTs) were performed using 6 databases. The quality of reviewed articles were assessed by the risk of bias using the Cochrane collaboration's tool. [Results] A total of 829 articles were found from the databases, of which 10 were finally selected to be included in this review. The overall risk of bias assessment indicated that the risk of bias was low in one study and high in the other nine studies. One study reported reduced pain and two studies reported reduced functional disability in the McKenzie exercise group compared to other exercises. Two studies reported reduced pain and three studies reported reduced functional disability in the stabilization exercise group compared to other exercises. In two studies, the stabilization exercise group was as effective as McKenzie exercise group in reducing pain and functional disability in patients with chronic nonspecific low back pain. [Conclusion] Only two studies compared stabilization and McKenzie exercises in the management of chronic nonspecific low back pain. Therefore, insufficient evidence is available to draw any conclusive comparison on the effects of McKenzie and stabilization exercises in chronic nonspecific low back pain. However, both McKenzie and stabilization exercises was better than conventional exercise programs in reducing functional disability in patients with chronic nonspecific low back pain.

Keywords: Low back pain; McKenzie exercises; Stabilization exercises.

Conflict of interest statement

None reported.

Figures

Fig. 1.
Fig. 1.
Results and process of literature search.
Fig. 2.
Fig. 2.
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.

References

    1. Dissanayaka TD: Level of awareness of body use in young people. IJSRP, 2014, 4: 2250–3153.
    1. Adams MA: Biomechanics of back pain. Acupunct Med, 2004, 22: 178–188.
    1. Kuppusamy S, Narayanasamy R, Christopher J: Effectiveness of Mckenzie exercises and mat based pilates exercises in subjects with chronic non-specific low back pain: a comparative study. Int J Prev Treat, 2013, 2: 47–54.
    1. Hoy D, Bain C, Williams G, et al. : A systematic review of the global prevalence of low back pain. Arthritis Rheum, 2012, 64: 2028–2037.
    1. Balagué F, Mannion AF, Pellisé F, et al. : Non-specific low back pain. Lancet, 2012, 379: 482–491.
    1. Bin Homaid M, Abdelmoety D, Alshareef W, et al. : Prevalence and risk factors of low back pain among operation room staff at a Tertiary Care Center, Makkah, Saudi Arabia: a cross-sectional study. Ann Occup Environ Med, 2016, 28: 1.
    1. Heyman E, Dekel H: Ergonomics for children: an educational program for elementary school. Work, 2009, 32: 261–265.
    1. Deyo RA, Dworkin SF, Amtmann D, et al. : Report of the NIH Task Force on research standards for chronic low back pain. Spine J, 2014, 14: 1375–1391.
    1. Airaksinen O, Brox JI, Cedraschi C, et al. COST B13 Working Group on Guidelines for Chronic Low Back Pain: Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J, 2006, 15: S192–S300.
    1. Deyo RA, Weinstein JN: Low back pain. N Engl J Med, 2001, 344: 363–370.
    1. Koes BW, van Tulder MW, Thomas S: Diagnosis and treatment of low back pain. BMJ, 2006, 332: 1430–1434.
    1. Russo M, Deckers K, Eldabe S, et al. : Muscle control and non-specific chronic low back pain. Neuromodulation, 2018, 21: 1–9.
    1. Waddell G, Feder G, McIntosh A, et al. : Low back pain evidence review London: Royal College of General Practitioners. J Manual Manip Ther, 1998, 6: 151–153.
    1. Jordan KM, Arden NK, Doherty M, et al. Standing Committee for International Clinical Studies Including Therapeutic Trials ESCISIT: EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis, 2003, 62: 1145–1155.
    1. Hammond A: Rehabilitation in rheumatoid arthritis: a critical review. Musculoskelet Care, 2004, 2: 135–151.
    1. Savigny P, Kuntze S, Watson P, et al. : Low back pain: early management of persistent non-specific low back pain. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners, 2009, 14.
    1. Aitken D, Buchbinder R, Jones G, et al. : Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Aust Fam Physician, 2015, 44: 39–42.
    1. Pencharz JN, Grigoriadis E, Jansz GF, et al. : A critical appraisal of clinical practice guidelines for the treatment of lower-limb osteoarthritis. Arthritis Res, 2002, 4: 36–44.
    1. van Baar ME, Dekker J, Oostendorp RA, et al. : The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial. J Rheumatol, 1998, 25: 2432–2439.
    1. Foley A, Halbert J, Hewitt T, et al. : Does hydrotherapy improve strength and physical function in patients with osteoarthritis--a randomised controlled trial comparing a gym based and a hydrotherapy based strengthening programme. Ann Rheum Dis, 2003, 62: 1162–1167.
    1. McKenzie R: The lumbar spine: mechanical diagnosis and therapy. Spinal Publications, 1997.
    1. McKenzie R, May S. The lumbar spine: mechanical diagnosis and therapy. Orthopedic Physical Therapy, Waikanae: Spinal Publications, 2003.
    1. Halliday MH, Pappas E, Hancock MJ, 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: 514–522.
    1. Aina A, May S, Clare H: The centralization phenomenon of spinal symptoms—a systematic review. Man Ther, 2004, 9: 134–143.
    1. George SZ, Childs JD, Teyhen DS, et al. : Rationale, design, and protocol for the prevention of low back pain in the military (POLM) trial (NCT00373009). BMC Musculoskelet Disord, 2007, 8: 92.
    1. Millisdotter M, Strömqvist B: Early neuromuscular customized training after surgery for lumbar disc herniation: a prospective controlled study. Eur Spine J, 2007, 16: 19–26.
    1. França FR, Burke TN, Caffaro RR, et al. : Effects of muscular stretching and segmental stabilization on functional disability and pain in patients with chronic low back pain: a randomized, controlled trial. J Manipulative Physiol Ther, 2012, 35: 279–285.
    1. O’Sullivan PB, Phyty GD, Twomey LT, et al. : Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine, 1997, 22: 2959–2967.
    1. Petersen T, Kryger P, Ekdahl C, et al. : 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. Spine, 2002, 27: 1702–1709.
    1. Paatelma M, Kilpikoski S, Simonen R, et al. : Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working adults: a randomized controlled trial with one year follow-up. J Rehabil Med, 2008, 40: 858–863.
    1. Garcia AN, Costa LC, da Silva TM, 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: 729–747.
    1. Murtezani A, Govori V, Meka VS, et al. : A comparison of mckenzie therapy with electrophysical agents for the treatment of work related low back pain: a randomized controlled trial. J Back Musculoskeletal Rehabil, 2015, 28: 247–253.
    1. Miller ER, Schenk RJ, Karnes JL, et al. : A comparison of the McKenzie approach to a specific spine stabilization program for chronic low back pain. J Manual Manip Ther, 2005, 13: 103–112.
    1. Hosseinifar M, Akbari M, Behtash H, et al. : The effects of stabilization and McKenzie exercises on transverse abdominis and multifidus muscle thickness, pain, and disability: a randomized controlled trial in nonspecific chronic low back pain. J Phys Ther Sci, 2013, 25: 1541–1545.
    1. Koumantakis GA, Watson PJ, Oldham JA: Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain. Phys Ther, 2005, 85: 209–225.
    1. Moon HJ, Choi KH, Kim DH, et al. : Effect of lumbar stabilization and dynamic lumbar strengthening exercises in patients with chronic low back pain. Ann Rehabil Med, 2013, 37: 110–117.
    1. Youssef MA: Effective sample size calculation: how many patients will I need to include in my study? Middle East Fertil Soc J, 2011, 16: 295–296.
    1. Schulz KF, Grimes DA: Multiplicity in randomised trials I: endpoints and treatments. Lancet, 2005, 365: 1591–1595.
    1. Turner MK, Hooten WM, Schmidt JE, et al. : Prevalence and clinical correlates of vitamin D inadequacy among patients with chronic pain. Pain Med, 2008, 9: 979–984.
    1. Ghosh S, Datta S, Nayak S, et al. : Comparative study of muscle strengthening exercises for treatment of chronic low backache. Medical Journal of Dr. DY Patil Vidyapeeth, 2014, 7: 443–446.
    1. Chitra R: Effect of lumbar stabilization exercise and lumbar extension exercise in the treatment of chronic low back pain. ESJ, 2014, 10: 123–131.
    1. Smith BE, Littlewood C, May S: An update of stabilisation exercises for low back pain: a systematic review with meta-analysis. BMC Musculoskelet Disord, 2014, 15: 416.
    1. Leeuw M, Goossens ME, Linton SJ, et al. : The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med, 2007, 30: 77–94.

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