TY - JOUR
T1 - McKenzie Method of Mechanical Diagnosis and Therapy was slightly more effective than placebo for pain, but not for disability, in patients with chronic non-specific low back pain
T2 - a randomised placebo controlled trial with short and longer term follow-up
AU - Garcia, Alessandra Narciso
AU - Costa, Lucíola Da Cunha Menezes
AU - Hancock, Mark J.
AU - De Souza, Fabrício Soares
AU - Gomes, Geórgia Vieira Freschi De Oliveira
AU - Almeida, Matheus Oliveira De
AU - Costa, Leonardo Oliveira Pena
PY - 2018/5
Y1 - 2018/5
N2 - Background: The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is one of the exercise approaches recommended by low back pain (LBP) guidelines. We investigated the efficacy of MDT compared with placebo in patients with chronic LBP. Methods: This was a prospectively registered, two-arm randomised placebo controlled trial, with a blinded assessor. A total of 148 patients seeking care for chronic LBP were randomly allocated to either MDT (n=74) or placebo (n=74). Patients from both groups received 10 treatment sessions over 5 weeks. Patients from both groups also received an educational booklet. Clinical outcomes were obtained at the end of treatment (5 weeks) and 3, 6 and 12 months after randomisation. Primary outcomes were pain intensity and disability at the end of treatment (5 weeks). We also conducted a subgroup analysis to identify potential treatment effect modifiers that could predict a better response to MDT treatment. Results: The MDT group had greater improvements in pain intensity at the end of treatment (mean difference (MD) -1.00, 95% CI -2.09 to -0.01) but not for disability (MD -0.84, 95% CI -2.62 to 0.93). We did not detect between-group differences for any secondary outcomes, nor were any treatment effect modifiers identified. Patients did not report any adverse events. Conclusion: We found a small and likely not clinically relevant difference in pain intensity favouring the MDT method immediately at the end of 5 weeks of treatment but not for disability. No other difference was found for any of the primary or secondary outcomes at any follow-up times.
AB - Background: The McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is one of the exercise approaches recommended by low back pain (LBP) guidelines. We investigated the efficacy of MDT compared with placebo in patients with chronic LBP. Methods: This was a prospectively registered, two-arm randomised placebo controlled trial, with a blinded assessor. A total of 148 patients seeking care for chronic LBP were randomly allocated to either MDT (n=74) or placebo (n=74). Patients from both groups received 10 treatment sessions over 5 weeks. Patients from both groups also received an educational booklet. Clinical outcomes were obtained at the end of treatment (5 weeks) and 3, 6 and 12 months after randomisation. Primary outcomes were pain intensity and disability at the end of treatment (5 weeks). We also conducted a subgroup analysis to identify potential treatment effect modifiers that could predict a better response to MDT treatment. Results: The MDT group had greater improvements in pain intensity at the end of treatment (mean difference (MD) -1.00, 95% CI -2.09 to -0.01) but not for disability (MD -0.84, 95% CI -2.62 to 0.93). We did not detect between-group differences for any secondary outcomes, nor were any treatment effect modifiers identified. Patients did not report any adverse events. Conclusion: We found a small and likely not clinically relevant difference in pain intensity favouring the MDT method immediately at the end of 5 weeks of treatment but not for disability. No other difference was found for any of the primary or secondary outcomes at any follow-up times.
KW - exercise
KW - low back pain
KW - McKenzie method
KW - placebo method
UR - http://www.scopus.com/inward/record.url?scp=85046376839&partnerID=8YFLogxK
U2 - 10.1136/bjsports-2016-097327
DO - 10.1136/bjsports-2016-097327
M3 - Article
C2 - 28701365
AN - SCOPUS:85046376839
VL - 52
SP - 594
EP - 600
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
SN - 0306-3674
IS - 9
ER -