The McKenzie Method Versus Manipulation for Patients With Chronic Low Back Pain

Not Applicable

Completed

Brief Summary: Introduction:

The McKenzie method as well as spinal manipulation is commonly used for the treatment of low back pain throughout the western world. Recently, the need for studies testing the effect of treatment strategies to specific diagnostic subgroups of patients has been emphasized. The present study aims to compare the effectiveness of the McKenzie method and chiropractic manipulation, information, and advice for patients with clinical signs of persistent symptoms originating from a diskus in the low back.

Methods:

After clinical screening 350 patients with or without leg pain who presented with centralization of symptoms or signs of disc herniation were randomized to the McKenzie group or the manipulation group. The outcome measures, Roland Morris Disability Questionnaire, 11 point numerical pain scale, 6 point global perceived change scale, and quality of life (Short Form-36) were assessed at baseline, at end of treatment, and at 2 and 12 months follow-up.

Detailed Description: In 1998, Cherkin et al. published a study showing no difference between outcomes following the McKenzie method, chiropractic manipulation, or the provision of an educational booklet for the treatment of patients with acute non-specific low back pain. Recently, the need for studies testing the effect of treatment strategies to specific diagnostic subgroups of patients has been emphasized. The present study aims to compare the effectiveness of the McKenzie method and chiropractic manipulation, information, and advice for patients with clinical signs of disc-related symptoms for duration of more than 6 Weeks.

Recruitment & Eligibility

Inclusion Criteria

18 to 60 years of age
suffering from low back pain (LBP) with or without leg pain for a period of more than 6 weeks
able to speak and understand the Danish language
with a presentation of clinical signs of disc-related symptoms.

Exclusion Criteria

positive non-organic signs
serious pathology suspected based on physical examination and/or magnetic resonance imaging
application for disability pension or pending litigation
pregnancy
comorbidity
recent back surgery
problems with communication

Primary Outcome Measures

Name	Time	Method
Disability	two months after treatment	Problems performing daily activities measured on the 23-item modified Roland Morris Disability Questionnaire (worst: 23 points, best:0 points).
Number of Patients With Treatment Success	Two months posttreatment	Treatment success was defined as a reduction of at least 5 points or an absolute score below 5 points on the 23-item modified Roland Morris Disability Questionnaire (best value: 0 points, worst value 23 points)

Secondary Outcome Measures

Name	Time	Method
Pain	twelve months posttreatment	The back and leg pain questionnaire included three separate 11 point box scales comprising the following items: Low Back Pain (LBP) at the moment, the worst LBP within the past two weeks, and the average level of LBP within the last two weeks. These summed to a total score ranging from 0 points (no back or leg pain at all) to 60 points (worst possible back and leg pain on all items).
Number of Patients on Sick Leave	twelve months posttreatment	Measured by self-report of beeing on sick leave at the moment because of LBP
Quality of Life	twelve months posttreatment	Quality of life, general health, measured on the Short Form 36 questionnaire (worst:100, best:0)
Cost Effectiveness	twelve months posttreatment

Locations (1): Back and Rehabilitation Center Copengagen
🇩🇰
Copenhagen, Copenhagen OE, Denmark
Back and Rehabilitation Center Copengagen
🇩🇰Copenhagen, Copenhagen OE, Denmark