Research in Physical Education, Sport and Health 2015, Vol. 4, No. 1, pp.79-86 ISSN(Print):1857-8152; ISSN(Online):1857-8160

EFFECTIVENESS OF THE MCKENZIE METHOD IN THE TREATMENT OF LOW BACK PAIN IN SUBACUTE AND CHRONIC STAGE UDC:616.711-085.8 (Original scientific paper)

Arbnore Ibrahimaj1, Samire Deliu2, Sylejman Miftari3 1

University of Pristina , Faculty of Medicine, Department of Physiotherapy, Pristina , Kosovo, 2 General Hospital ‘Rezonanca’, Pristina, Kosovo

Abstract Introduction: Low back pain is a highly prevalent condition worldwide. Physiotherapists commonly use a system of diagnosis and exercise prescription called the McKenzie Method to manage patients with low back pain. Objective: The main aim of this study was to evaluate the effectiveness of the Mckenzie method treatment, in sub-acute and chronic low back pain. Meterial and methods: Our study was conducted between years 2009-2010 , in General Hospital “Rezonanca”, in physical therapy care. We did a short-term, prospective study in duration of 15 days. The total number of patients enrolled in the study was 100, age above 23 years, of both sexes. Patients were treated with McKenzie Method, the assessment was done before and after the treatment .We used the Numeric Rating Scale to assess the pain, and Modified Schober’s test for mobility. Results: McKenzie method increases the mobility and reduces the pain in the lumbar region more on sub-acute stage. Short-term treatment of patients, (on subacute and chronic stage) with the McKenzie method is more effective in reducing pain. McKenzie method is most effective in patients in sub-acute stage. Conclusions: Chronic low back pain patients need to be treated for longer periods, with the McKenzie Method. Our recommendation is to further research the efficacy of Mckenzie method for longer periods, larger sample size, with randomized, crossed –over, double-blind, placebo-controlled treatment groups, in order to avoid bias. Key words: Numeric rating scale, Schober, exercise program, extension, flexion

Introduction Low back pain (LBP) is one of the most prevalent health conditions and the most expensive which affect the developed world (2,3,4,5). It is also one of the most common muscular- skeletal conditions treated by physical therapists (6). The aim of the research is to demonstrate the efficiency of the McKenzie method in treating pain in the lower back in sub-acute and chronic stage. The primary goal is to set the frequency of patients in sub-acute and chronic phase and compare the degree of pain according to Numerical Assessment Scale (Numeric Rating Scale), before and after treatment (15days). Secondary goal is to assess and compare the lumbar mobility, flexion and extension, according to Modified Shober's test in chronic and sub-acute phase. Material & Methods The research was conducted at the General Hospital "Rezonanca", in Pristina, in the period 20092010. The total number of patients included in the research was 100, aged about 23 years, of both sexes, with pain in the lower back for more than four weeks (sub-acute and chronic phases). The survey was short-term, lasting 15 days and prospective. The patients were underwent physical therapy by Reumatologist, orthopedist and neurosurgeon. According to clinical evaluation, all patients were classified with Disorder Syndrome. The patients were treated with exercise program of McKenzie method, which represents the program of exercises of extension and flexion. The patients did exercises every day in the clinic, under the supervision of physiotherapist and continued the exercises at home. Repetition of exercises was performed for five times during the day, 5-10 repetitions of each exercise. In the first visit and the second visit, after 15 days, the assessment of the degree of pain according Numerical Assessment Scale of pain (NRS) was conducted, range of active motion in the lumbar region was measured with Modified Shober's Test and Lasegue’s. www.pesh.mk

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EFFECTIVENESS OF THE MCKENZIE METHOD IN …

Statistical Analysis and presentation of data is done through tables. Data processing was done with the statistical package InStat. Of statistical parameters were calculated: arithmetic mean, standard deviation, and minimum and maximum values. For testing nonparametric data it is used the x2-test and Fisher's test, while for parametric data, the t-test was used. Verification of tests for the degree of reliability was 95% and 99%, respectively p 0:05) (Table 2). Table 3. Values of Lasegue’s test before and after treatment (15 days) Lasegue’s test

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Day 1

Day 15

Positive

N 57

% 57

N 23

% 23

Negative

43

43

77

77

Totally X2-testi

100

100

100

100

P