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A randomized clinical trial comparing the McKenzie method and motor control exercises in people with chronic low back pain and a directional preference: 1-year follow-up
Authors:Mark H. Halliday  Evangelos Pappas  Mark J. Hancock  Helen A. Clare  Rafael Z. Pinto  Gavin Robertson  Paulo H. Ferreira
Affiliation:1. Concord Repatriation General Hospital, Hospital Rd, Concord, Australia;2. The University of Sydney, Faculty of Health Sciences, Discipline of Physiotherapy, 75 East St, Lidcombe, Australia;3. Macquarie University, Faculty of Medicine and Health Science, Herring Rd, North Ryde, Australia;4. Helen Clare Physiotherapy, 263 Pacific Highway, Crows Nest, Australia;5. Sao Paulo State University, Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo, Brazil
Abstract:ObjectiveThe primary objective of this study was to compare the long-term (1-year follow-up) effects of the McKenzie method and motor control exercises on trunk muscle thickness in people with chronic low back pain (LBP) and a directional preference.DesignRandomized controlled trial.SettingA secondary public health facility in Sydney, Australia.ParticipantsSeventy adults with greater than 3-month history of LBP and a directional preference.InterventionsParticipants were randomized to receive 12 treatments of either the McKenzie method or motor control exercises over 8-weeks.Outcome measuresMuscle thickness of the transversus abdominis, obliquus internus, and obliquus externus measured from ultrasound images. Secondary outcomes included function, perceived recovery, and pain. Outcomes were collected at baseline, post intervention at 8-weeks, and at 1-year follow-up by blinded assessors. The current paper focuses on the 1-year follow-up.ResultsFifty-eight participants completed data collection for the primary outcome at 1-year. There were no significant between group differences for changes in trunk muscle thickness for any of the three investigated muscles: transversus abdominis [3%, 95% confidence interval (CI): ?5%, 11%], obliquus internus [?4%, 95% CI: ?9%, 2%] and obliquus externus [3%, 95% CI: ?4%, 11%]. Similarly, there were no significant differences between groups for the secondary outcomes of function, perceived recovery and pain.ConclusionTrunk muscle thickness, function, perceive recovery and pain are similar between patients receiving McKenzie method or motor control exercises at a 1-year follow-up in a population of people with chronic LBP and a directional preference.
Clinical Trials Registration number CTRN12611000971932.
Keywords:Corresponding author at: Physiotherapy, Concord Repatriation General Hospital, Hospital Rd, 2139, Australia.  Mechanical Diagnosis and Therapy  Core stability  Trunk muscle recruitment  Ultrasound
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