Effectiveness of the back school and mckenzie techniques in patients with chronic non-specific low back pain: a protocol of a randomised controlled trial

Abstract

BackgroundChronic low back pain is a highly prevalent condition, which is associated with high direct and indirect costs to the society. Although this condition is highly prevalent, it is still extremely difficult to treat. Two potentially useful treatments for patients with chronic low back pain are called the McKenzie and Back School treatment programs. These programs have good biological plausibility, are widely available and have a modest cost. Although these treatments are already available for patients, the evidence that supports their use is largely based on low quality methodological studies. Therefore, a high-quality randomised controlled trial is required to compare, for the first time, the effectiveness of these treatments in patients with chronic low back pain.Methods/designOne hundred and forty-eight patients will be randomly allocated to a four-week treatment program based upon the McKenzie or Back School principles. Clinical outcomes (pain intensity, disability, quality of life, and trunk flexion range of motion) will be obtained at follow-up appointments at 1, 3 and 6 months after randomisation. The data will be collected by an assessor who will be blinded to the group allocation.DiscussionThis will be the first study aimed to compare the McKenzie and Back School approaches in patients with chronic low back pain. The results of this trial may help in the decision-making process of allied health providers for the treatment of chronic low back pain and reduce the health-related costs of this condition.Trial RegistrationACTRN12610000435088

A comparison of McKenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial

“…The McKenzie method was superior to other treatments with regard to short-term pain relief and disability [20,21]. In our study the decrease in back pain in the McKenzie therapy group was in line with earlier findings [11,22] which showed similar results (short-term pain relieve) to those in a recent study.…”

“…its randomized controlled design. According to subjects' characteris-tics at baseline, our subjects were similar and corresponded to those of similar studies [19,21,33]. Subjects' adherence to the treatment program was satisfactory and we had a low rate of loss to follow-up.…”

A comparison of McKenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial

“…The McKenzie method was superior to other treatments with regard to short-term pain relief and disability [20,21]. In our study the decrease in back pain in the McKenzie therapy group was in line with earlier findings [11,22] which showed similar results (short-term pain relieve) to those in a recent study.…”

“…its randomized controlled design. According to subjects' characteris-tics at baseline, our subjects were similar and corresponded to those of similar studies [19,21,33]. Subjects' adherence to the treatment program was satisfactory and we had a low rate of loss to follow-up.…”

Reducing lumbar spine flexion using real-time biofeedback during patient handling tasks

“…These training sessions typically include discussion of directives like "lift with your legs, not with you back" in an attempt to train workers to avoid spine flexion [46]. However, this type of training has been found to be ineffective at reducing the risk of injury [47][48][49][50][51][52]. Perhaps these results should come as no surprise considering the shocking lack of evidence supporting how the actual training methods that are deployed.…”

Lumbopelvic Stabilization Exercises and McKenzie Method in Low Back Pain Due to Disc Protrusion: A Blind Randomized Clinical Trial

“…We defined the treatment from the result of the evaluation performed prior to the randomization stage, and guided it according to the preferred direction of movement, that is flexion, extension, or lateral displacement of the spine. We applied the McKenzie protocol according to Garcia et al (13) (table I).…”

A comparison of McKenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial

“…The McKenzie method was superior to other treatments with regard to short-term pain relief and disability [20,21]. In our study the decrease in back pain in the McKenzie therapy group was in line with earlier findings [11,22] which showed similar results (short-term pain relieve) to those in a recent study.…”

“…its randomized controlled design. According to subjects' characteris-tics at baseline, our subjects were similar and corresponded to those of similar studies [19,21,33]. Subjects' adherence to the treatment program was satisfactory and we had a low rate of loss to follow-up.…”

Reducing lumbar spine flexion using real-time biofeedback during patient handling tasks

“…These training sessions typically include discussion of directives like "lift with your legs, not with you back" in an attempt to train workers to avoid spine flexion [46]. However, this type of training has been found to be ineffective at reducing the risk of injury [47][48][49][50][51][52]. Perhaps these results should come as no surprise considering the shocking lack of evidence supporting how the actual training methods that are deployed.…”

Lumbopelvic Stabilization Exercises and McKenzie Method in Low Back Pain Due to Disc Protrusion: A Blind Randomized Clinical Trial

“…We defined the treatment from the result of the evaluation performed prior to the randomization stage, and guided it according to the preferred direction of movement, that is flexion, extension, or lateral displacement of the spine. We applied the McKenzie protocol according to Garcia et al (13) (table I).…”

A comparison of McKenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial

“…The McKenzie method was superior to other treatments with regard to short-term pain relief and disability [20,21]. In our study the decrease in back pain in the McKenzie therapy group was in line with earlier findings [11,22] which showed similar results (short-term pain relieve) to those in a recent study.…”

“…its randomized controlled design. According to subjects' characteris-tics at baseline, our subjects were similar and corresponded to those of similar studies [19,21,33]. Subjects' adherence to the treatment program was satisfactory and we had a low rate of loss to follow-up.…”

Reducing lumbar spine flexion using real-time biofeedback during patient handling tasks

“…These training sessions typically include discussion of directives like "lift with your legs, not with you back" in an attempt to train workers to avoid spine flexion [46]. However, this type of training has been found to be ineffective at reducing the risk of injury [47][48][49][50][51][52]. Perhaps these results should come as no surprise considering the shocking lack of evidence supporting how the actual training methods that are deployed.…”

Lumbopelvic Stabilization Exercises and McKenzie Method in Low Back Pain Due to Disc Protrusion: A Blind Randomized Clinical Trial

“…We defined the treatment from the result of the evaluation performed prior to the randomization stage, and guided it according to the preferred direction of movement, that is flexion, extension, or lateral displacement of the spine. We applied the McKenzie protocol according to Garcia et al (13) (table I).…”