McKenzie Therapists Adhere More to  Evidence-Based Guidelines and Have a More Biopsychosocial Perspective on the  Management of Patients with Low Back Pain than General Physical Therapists in Japan

Takasaki, Hiroshi; Saiki, Taku; Iwasada, Yoshihiro

doi:10.4236/ojtr.2014.24023

Cited by 25 publications

(30 citation statements)

References 18 publications

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“…In addition, DPT with a biomedical orientation showed a significant positive weak correlation (r= 0.510) with the recognition of symptoms in clinical vignette 2 (neuropathic pain). These results are in line with other studies [1,7,15].…”

supporting

confidence: 94%

RELATIONSHIP BETWEEN DECISION-MAKING IN LBP AND KNOWLEDGE, ATTITUDES, BELIEFS, AND INTOLERANCE OF UNCERTAINTY AMONG DPTs

FAKHRO¹,

Molook²,

Wehbe³

et al. 2017

IJPR

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Background: Low back pain (LBP) remains a prevalent health problem that is characterized by ambiguity and can progress towards chronic disability. Recently, researchers have started to focus on understanding whether and how attitudes and beliefs of health professionals influence their decisions and outcomes among LBP patients.Objectives: The purpose of this study was to characterize Lebanese doctors of physical therapy (DPT)s attitudes and beliefs towards LBP and its management. A secondary objective was to examine whether and how DPTs own intolerance of uncertainty (IU), knowledge and treatment orientation predicts work and activity recommendations among their LBP patients.Methods: A national survey targeted 129 physical therapist (PT) and included: 1) a filter question; 2) sociodemographic section; 3) a question about recent LBP clinical practice guidelines (CPGs) knowledge; 4) pain attitudes and beliefs scale for physiotherapists (PABS-PT); 5) intolerance of uncertainty scale-12 (IUS-12); 6) and two clinical vignettes that described patients with LBP.Results: A total of 16 DPT completed the survey, of those, 62.5% followed a biomedical orientation, and were restrictive in the recommendations given to their patients. In addition, knowledge of CPGs showed a significant strong relationship with IU (P=0.005) and the recommendation to return to activity (RA) in vignette 1(P= 0.031). Discussion:The current results showed partial adherence to recent LBP guidelines, where most of the DPTs had a biomedical orientation that impacted negatively their recommendations for patients with LBP and DPTs who showed knowledge of LBP CPGs had the lowest IU and tended not to be restrictive in their recommendations to RA.

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supporting

confidence: 94%

RELATIONSHIP BETWEEN DECISION-MAKING IN LBP AND KNOWLEDGE, ATTITUDES, BELIEFS, AND INTOLERANCE OF UNCERTAINTY AMONG DPTs

FAKHRO¹,

Molook²,

Wehbe³

et al. 2017

IJPR

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“…One approach, which captures mechanical and psychosocial elements of a biopsychosocial approach, is the McKenzie method (Takasaki, Saiki, & Iwasada, 2014). The McKenzie mechanical evaluation is designed to identify a directional preference (DP).…”

Section: Introductionmentioning

confidence: 99%

“…The McKenzie approach also includes a psychosocial element (Takasaki et al, 2014). This element focuses on changing patients' pain behaviours and cognitions through patient education and is designed to empower patients to attain active self-management strategies and problem-solving techniques to self-control symptoms (May, 2007;May & Donelson, 2008;McKenzie & May, 2003).…”

Section: Introductionmentioning

confidence: 99%

Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain

Edmond

Werneke

Young

et al. 2019

Physiotherapy Res Intl

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Objectives Graded activity and graded exposure are recommended cognitive behavioural approaches to improve function and pain outcomes for patients receiving physiotherapy for chronic nonspecific low back pain. Directional preference identified following the McKenzie method is also associated with favourable patient outcomes. Study objectives were to examine associations between graded activity and/or graded exposure, and directional preference or no directional preference combined with or without graded activity/graded exposure subgroups, and function and pain outcomes among patients with chronic nonspecific low back pain managed by clinicians credentialed in the McKenzie approach. Method Cohort study: Subjects (n = 801) with chronic nonspecific low back pain completed intake surveys, that is, the Lumbar Computer Adaptive Test measuring function and the Numeric Pain Rating Scale measuring pain, and questions addressing their demographic, lifestyle, and health status. Directional preference was determined at intake. Treatment with graded activity/graded exposure during the episode of care was recorded. Function and pain measures were repeated at discharge. Two models were developed controlling for potential confounding effects. The first model examined associations between patients receiving versus not receiving graded activity/graded exposure. The second model examined interaction effects between four combinations of directional preference and graded activity/graded exposure. Outcome measures were changes in function and pain during rehabilitation. Results Regarding the first objective, there were no clinically relevant differences between treatment versus no treatment with graded activity/graded exposure, and functional outcomes. Regarding the second objective, patients in the no‐directional preference group were more likely to see benefits from the addition of graded activity/graded exposure to their treatment groups than those with a directional preference. Conclusion Clinicians using McKenzie methods might attain improved patient functional outcomes when augmenting treatment with graded activity and/or graded exposure among patients who do not demonstrate directional preference.

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“…Problem solving and active self‐care are educational interventions that are emphasized in both the McKenzie approach (May, ; May & Donelson, ; McKenzie & May, ; Takasaki, Saiki, & Iwasada, ) and CBA (Main, Sowden, Hill, Watson, & Hay, ), including those involved with GA and GEX interventions. One possible explanation for our findings of no clinically meaningful difference in function or pain outcomes when comparing intervention with GA/GEX versus no GA/GEX is that the patient education elements of the McKenzie approach may be similar to those of GA/GEX, thereby negating much of the effect of GA/GEX in our study population.…”

Section: Discussionmentioning

confidence: 99%

“…Problem solving and active self-care are educational interventions that are emphasized in both the McKenzie approach (May, 2007;May & Donelson, 2008;McKenzie & May, 2006;Takasaki, Saiki, & Iwasada, 2014) and CBA (Main, Sowden, Hill, Watson, & Hay, 2012),…”

Section: Discussionmentioning

confidence: 99%

Cognitive behavioural interventions, and function and pain outcomes among patients with chronic neck pain managed with the McKenzie approach

Edmond

Werneke²,

Young

et al. 2019

Musculoskeletal Care

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Objectives Graded activity and graded exposure in vivo are recommended cognitive behavioural approaches to improve function and pain outcomes for patients receiving physiotherapy for chronic nonspecific neck pain. The McKenzie method is a common treatment approach for patients with neck pain. The study objectives were to examine associations between interventions with graded activity and/or graded exposure, as determined by the treating physiotherapist, and function and pain outcomes for patients with chronic nonspecific neck pain managed by clinicians with credentials in the McKenzie approach. Method A cohort study was carried out, in which subjects (n = 366) with chronic nonspecific neck pain completed intake surveys (i.e., the Neck Functional Status Computerized Adaptive Test and the Numeric Pain Rating Scale), and questions related to their demographic, lifestyle and health status. Treatment with graded activity/graded exposure during the episode of care was recorded. Function and pain measures were repeated at discharge. Multivariable models examining associations between patients receiving versus not receiving graded activity/graded exposure, and pain and function outcomes were constructed, controlling for potential confounding effects. Results Despite statistical significance, there were no clinically relevant differences between treatment versus no treatment with graded activity/graded exposure, and function or pain outcomes. Conclusion There is insufficient evidence to suggest that patients being managed with McKenzie methods will attain clinically relevant improvements in function or pain outcomes when augmenting treatment with graded activity and/or graded exposure when the choice to intervene with these cognitive behavioural approaches is determined by the treating physiotherapist.

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McKenzie Therapists Adhere More to Evidence-Based Guidelines and Have a More Biopsychosocial Perspective on the Management of Patients with Low Back Pain than General Physical Therapists in Japan

Cited by 25 publications

References 18 publications

RELATIONSHIP BETWEEN DECISION-MAKING IN LBP AND KNOWLEDGE, ATTITUDES, BELIEFS, AND INTOLERANCE OF UNCERTAINTY AMONG DPTs

RELATIONSHIP BETWEEN DECISION-MAKING IN LBP AND KNOWLEDGE, ATTITUDES, BELIEFS, AND INTOLERANCE OF UNCERTAINTY AMONG DPTs

Directional preference, cognitive behavioural interventions, and outcomes among patients with chronic low back pain

Cognitive behavioural interventions, and function and pain outcomes among patients with chronic neck pain managed with the McKenzie approach

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