Observations placeholder
Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial
Identifier
027631
Type of Spiritual Experience
Background
A description of the experience
Phys Ther. 2013 Jun;93(6):729-47. doi: 10.2522/ptj.20120414. Epub 2013 Feb 21.
Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial.
Garcia AN1, Costa Lda C, da Silva TM, Gondo FL, Cyrillo FN, Costa RA, Costa LO.
BACKGROUND:
Back School and McKenzie methods are popular active treatment approaches that include both exercises and information for patients with chronic nonspecific low back pain.
OBJECTIVE:
The purpose of this study was to compare the effectiveness of Back School and McKenzie methods in patients with chronic nonspecific low back pain.
DESIGN:
The study was a prospectively registered, 2-arm randomized controlled trial with a blinded assessor.
SETTING:
The study was conducted in the outpatient physical therapy clinic in São Paulo, Brazil.
PATIENTS:
The study participants were 148 patients with chronic nonspecific low back pain.
INTERVENTIONS:
The 4-week treatment program (one session/week) was based on the Back School (delivered to the group) or McKenzie (delivered individually) principles. The participants also were instructed to perform a daily set of home exercises.
MEASUREMENTS:
Clinical outcomes were assessed at follow-up appointments at 1, 3, and 6 months after randomization. Primary outcome measures were pain intensity (measured by the 0-10 pain numerical rating scale) and disability (measured by the 24-item Roland-Morris Disability Questionnaire) 1 month after randomization. Secondary outcome measures were pain intensity and disability at 3 and 6 months after randomization, quality of life (measured by the World Health Organization Quality of Life-BREF instrument) at 1, 3, and 6 months after randomization, and trunk flexion range of motion measured by an inclinometer at 1 month after randomization. The data were collected by a blinded assessor.
RESULTS:
Participants allocated to the McKenzie group had greater improvements in disability at 1 month (mean effect=2.37 points, 95% confidence interval=0.76 to 3.99) but not for pain (mean effect=0.66 points, 95% confidence interval=-0.29 to 1.62). No between-group differences were observed for all secondary outcome measures.
LIMITATIONS:
It was not possible to monitor the home exercise program. Therapists and participants were not blinded.
CONCLUSIONS:
The McKenzie method (a more resource-intensive intervention) was slightly more effective than the Back School method for disability, but not for pain intensity immediately after treatment in participants with chronic low back pain.
PMID:
23431213