A Randomized Controlled Trial Comparing the McKenzie Method to Motor Control Exercises in People With Chronic Low Back Pain and a Directional Preference
Authors: Mark H. Halliday, PT
Study Design
Randomized clinical trial.
Background
Motor control exercises are believed to improve co-ordination of the trunk muscles. It is unclear if increases in trunk muscle thickness can be facilitated by approaches such as the McKenzie method. Furthermore it is unclear if either approach is superior regarding clinical outcomes.
Objectives
The primary aim was to compare the effects of the McKenzie method and motor control exercises on trunk muscle recruitment in people with chronic low back pain (LBP) classified with a directional preference. Secondary aims included a between group comparison for pain, function, and global perceived effect.
Methods
Seventy people with chronic LBP demonstrating a directional preference using the McKenzie assessment were randomized to receive 12 treatments over 8 weeks with the McKenzie or motor control approaches. All outcomes were collected at baseline and at 8-week follow-up by blinded assessors.
Results
No significant between group difference was found for trunk muscle thickness of the transversus abdominis [-5.8%, 95% CI -15.2 to 3.7], obliquus internus [-0.7%, 95% CI -6.6 to 5.2] and obliquus externus [1.2%, 95% CI -4.3 to 6.8]. Perceived recovery was slightly superior in the McKenzie group (-0.8, 95% CI -1.5 to -0.1] on a -5 to +5 scale. No significant between-group differences were found for pain or function [p= 0.99, 0.26, respectively].
Conclusion
We found no statistically significant effect for treatment group for trunk muscle thickness. Participants reported a slightly greater sense of perceived recovery with the McKenzie method than with the motor control approach.
Level of Evidence
Therapy, level 1b-. J Orthop Sports Phys Ther, Epub 12 May 2016. doi:10.2519/jospt.2016.6379