Browder et al.1313 Browder DA, Childs JD, Cleland JA, Fritz JM. Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: a randomized clinical trial. Phys Ther. 2007;87(12):1608-18; discussion 1577-9.
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48 patients (15 females), aged 18-60 years; symptoms distal to gluteus which centralized with extension movements. |
(G1) eight physiotherapy sessions for lumbar spine extension (exercises + mobilizations) associated to home exercises program (n=26) (G2) eight physiotherapy sessions for strengthening (isolated contractions of abdominal and spine stabilizing muscles) associated to home exercises program (n=22). |
G1 compared to G2: G1had more significant evolution in dysfunction measurement (ODQ) after one week and six month of follow up and has also improved pain (NPRS) just after one week follow up. |
Garcia et al.1414 Garcia AN, Costa Lda C, da Silva TM, Gondo FL, Cyrillo FN, Costa RA, et al. Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Phys Ther. 2013;93(6):729-47.[8/10] |
148 patients (109 females), aged 18-80 years; nonspecific low back pain symptoms for at least three months |
(G1) four individual sessions lasting 45 minutes to one hour, 1x/week with MDT, based on directional movements preference (n=74). (G2) four sessions being the first individual and remaining in groups, lasting 45 minutes to one hour, 1x/week made up of theoretical and practical orientations according to the Back School method (n=74) |
G1 compared to G2: better functional performance index (RMDQ) after one month of treatment, however with no differences in pain measurement. |
Long, Donelson & Fung1515 Long A, Donelson R, Fung T. Does it matter which exercise? A randomized control trial of exercise for low back pain. Spine. 2004;29(23):2593-602.[8/10] |
312 patients (146 females), aged 18-65 years; low back pain and sciatic pain. Those with directional preference (n=230) were included and 201 participants have concluded the study. |
(G1) exercises compatible with directional preference presented during evaluation for two weeks (n=80) (G2) exercises compatible with directional preference opposed to that presented during evaluation for two weeks (n=70). (G3) exercises without directional approach for two weeks (n=80). |
1/3 of G2 and G3 participants have abandoned treatment two weeks later due to worsening or lack of improvement of symptoms; no G1 member has quit. There were significant improvements in G1 as compared to G2 and G3 in all measurements (RMDQ, VAS, BDI) and decreased drug use. |
Machado et al.1616 Machado LA, Maher CG, Herbert RD, Clare H, McAuley JH. The effectiveness of the McKenzie method in addition to first-line care for acute low back pain: a randomized controlled trial. BMC Med. 2010;8:10.[8/10] |
148 patients (73 females), aged 18-80 years; nonspecific acute low back pain symptoms. 138 participants have concluded the study and 2 were excluded soon after randomization. |
(G1) general orientations on how to keep active and avoid remaining for long periods in bed, confirmation of favorable acute low back pain prognosis and administration of paracetamol in specific hours (n=73). (G2) G1 + MDT-based protocol (n=73). |
G2: Differences (p>0.05) in pain perception (NRS) and looked for less additional health care. |
Paatelma et al.1717 Paatelma M, Kilpikoski S, Simonen R, Heinonen A, Alen M, Videman T. Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working adults: a randomized controlled trial with one year follow-up. J Rehabil Med. 2008;40(10):858-63.[7/10] |
134 patients, aged 18-65 years; symptoms of nonspecific low back pain with or without irradiation to one or both legs. |
(G1) manual orthopedic therapy, with maximum of seven sessions lasting from 30 to 45 minutes each (n=45). (G2) Treatment according to MDT, with maximum of seven sessions lasting 30 to 45 minutes each (n=52). (G3) Just orientations in one-hour session (n=37). |
After three months, six months and one year follow up there were no significant differences between G1 and G2; as compared to G3, interventions carried out by G1 and G2 were more effective, however without statistical significance. |
Petersen et al.1818 Petersen T, Larsen K, Nordsteen J, Olsen S, Fournier G, Jacobsen S. The McKenzie method compared with manipulation when used adjunctive to information and advice in low back pain patients presenting with centralization or peripheralization: a randomized controlled trial. Spine. 2011;36(24):1999-2010.[7/10] |
350 patients (265 females), aged 18-60 years; low back pain symptoms for more than six weeks with centralization of peripheralization, with or without irradiation. |
(G1) Treatment according to MMK, individually planned for each patient. For G1, approaches involving vertebral mobilization techniques, including high velocity maneuvers were prohibited (n=175). (G2) All types of manual techniques, including vertebral mobilizations, high velocity maneuvers and trigger-points therapy. For G2 specific exercises in preference directions were prohibited (n=175). |
G1: higher success rate of treatment according to RMDQ scores, reaching statistical significance in the follow up of 2 and 1. |