Author Names
Namnaqani FI, Mashabi AS, Yaseen KM, Alshehri MA
Reviewer Name
Angelo Pata SPT
Reviewer Affiliations
Duke University School of Medicine, Doctor of Physical Therapy Division
Paper Abstract
The aim of this study was to evaluate the effectiveness of the McKenzie method compared to manual therapy in the management of patients with chronic low back pain (CLBP). Randomised controlled trials evaluating the McKenzie method in treating CLBP in adults compared to manual therapy (MT) were searched in MEDLINE, CINAHL, Cochrane Library, and PEDro. The primary outcomes were pain and disability. Five trials were eligible for inclusion in the review, of which, most had a score of 8 out of 11 on the PEDro scale. At 2-3 months, all studies reported significant improvement in the pain level in the McKenzie group, and more than that in the MT group. At 6 months, significant improvements had occurred in the disability index reported by two trials in the McKenzie group than the MT group. At 12 months follow-up, there were no significant differences in measures of LBP, but three studies reported that the McKenzie method group had a better disability level than the MT group. In patients with CLBP, many pain measures showed that the McKenzie method is a successful treatment to decrease pain in the short term, while the disability measures determined that the McKenzie method is better in enhancing function in the long term.
NIH Risk of Bias Tool
Quality Assessment of Systematic Reviews and Meta-Analyses
- Is the review based on a focused question that is adequately formulated and described?
- Yes
- Were eligibility criteria for included and excluded studies predefined and specified?
- Yes
- Did the literature search strategy use a comprehensive, systematic approach?
- Yes
- Were titles, abstracts, and full-text articles dually and independently reviewed for inclusion and exclusion to minimize bias?
- Yes
- Was the quality of each included study rated independently by two or more reviewers using a standard method to appraise its internal validity?
- Yes
- Were the included studies listed along with important characteristics and results of each study?
- Yes
- Was publication bias assessed?
- Yes
- Was heterogeneity assessed? (This question applies only to meta-analyses.)
- Cannot Determine, Not Reported, Not Applicable
Key Finding #1
In the short term (2-3 months), the McKenzie method was more effective than Manual therapy in terms of pain level in patients with chronic low back pain.
Key Finding #2
In the long term (6 months), the McKenzie method showed better disability index scores than manual therapy for patients with chronic low back pain.
Key Finding #3
The McKenzie method was shown to be superior in this study to manual therapy when treating patients with low back pain. However, both treatment methods were shown to be effective.
Please provide your summary of the paper
This study used randomized control trials (RCTs) to compare the effectiveness of the McKenzie method versus manual therapy when treating patients with chronic low back pain (CLBP). The study utilized qualitative and quantitative methods from The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to perform data analysis. It was found that the McKenzie method and manual therapy were both effective treatment strategies for patients with CLBP. However, in the short term (2-3 months) the McKenzie method was found to have greater decreases in patient pain. Also, compared to manual therapy, the McKenzie method showed improved disability scores in the long term for patients with CLBP.
Please provide your clinical interpretation of this paper. Include how this study may impact clinical practice and how the results can be implemented.
If the goal is to decrease pain in the short term, and improve function in the long term, the McKenzie method would be the preferred choice over manual therapy when treating a patient with CLBP. However, it is critical to keep in mind that manual therapy is also an effective modality for treating CLBP. Clinically, this research indicates utilization of the McKenzie method over manual therapy for a patient with CLBP. However, as clinicians, it is vital to keep in mind that not all methods of treatment shown to be superior through research will be the most effective choice for every patient. Trying the McKenzie method first may be a suitable choice. If the method does not produce the desired results, moving to another validated method like manual therapy would be indicated to treat patients with CLBP.
