Effects of Core Stability and Mckenzie Exercises in Mechanical Non Specific low Back Pain with Extension Preference
-
Hamidreza Nemati
,
Hoda Niknam
,
Khosro Khademi Kalantari
,
Alireza Akbarzadeh Baghban
,
Negin Jalili
Abstract
Objective: Low back pain is a leading cause of disability worldwide. To address this prevalent issue, various treatments have been recommended, with core stability and McKenzie exercises being among the most evidence-based options. However, recent comparison studies lack mechanical assessment and functional tests. This study aims to compare the effects of core stability and McKenzie exercises on range of motion, pain, disability, and function in patients with mechanical low back pain.
Materials & Methods: In this clinical trial, 22 patients received core stability exercises, and 22 patients received McKenzie exercises based on individual mechanical assessments. Before treatment, each patient underwent mechanical assessment via the McKenzie Mechanical Assessment form, pain assessment using the Visual Analog Scale (VAS), disability evaluation with the Oswestry Disability Index (ODI) questionnaire, muscle control and function assessment with unilateral single limb stance, and range of motion evaluation using fingertip-to-floor (FTF) distance measurements. After eight sessions over two weeks of intervention, all variables were measured again.
Results: Both groups showed significant improvements in trunk flexion range of motion, disability, functional status and pain (P > 0.05). However, there were no significant differences between the two groups (P < 0.05).
Conclusion: Both core stabilization and McKenzie exercises are effective in reducing pain, disability, increasing range of motion, and enhancing functional status in patients with mechanical low back pain.
1. Dutta A SA, S SK. A. COMPARATIVE STUDY TO FIND OUT THE EFFECTIVENESS BETWEEN CORE STABILIZATION VS MCKENZIE EXERCISES IN THE TREATMENT OF PATIENTS WITH MECHANICAL LOW BACK PAIN. Int J Physio [Internet] 2015 Oct 9 2015;2(5)(791-7).
2. Owen PJ, Miller CT, Mundell NL, Verswijveren SJ, Tagliaferri SD, Brisby H, et al. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British journal of sports medicine. 2020;54(21):1279-87.
3. Coulombe BJ, Games KE, Neil ER, Eberman LE. Core stability exercise versus general exercise for chronic low back pain. Journal of athletic training. 2017;52(1):71-2.
4. Lee J-Y, Lee D-Y. The effect of therapeutic abdominal drawing-in maneuver using ultrasonography on lateral abdominal muscle thickness and balance. Journal of Back and Musculoskeletal Rehabilitation. 2018;31(6):1139-43.
5. Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC musculoskeletal disorders. 2021;22:1-13.
6. SA F. Effect Of Lumbar Stabilization Versus Mckenzie Exercises On Pain And Functional Disability In Patients With Post Laminectomy Syndrome: A Randomized Controlled Trial. International Journal of Recent Advances in Multidisciplinary Research. 2019;06(06):5.
7. Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, et al. Neck pain: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy. 2017;47(7):A1-A83.
8. Vleeming A, Schuenke M, Danneels L, Willard F. The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. Journal of anatomy. 2014;225(4):447-62.
9. Tsao H, Druitt TR, Schollum TM, Hodges PW. Motor training of the lumbar paraspinal muscles induces immediate changes in motor coordination in patients with recurrent low back pain. The journal of pain. 2010;11(11):1120-8.
10. Tsao H, Hodges PW. Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. Journal of electromyography and kinesiology. 2008;18(4):559-67.
11. Hoffman SL, Johnson MB, Zou D, Harris-Hayes M, Van Dillen LR. Effect of classification-specific treatment on lumbopelvic motion during hip rotation in people with low back pain. Manual therapy. 2011;16(4):344-50.
12. Kim TH, Kim E-H, Cho H-y. The effects of the CORE programme on pain at rest, movement-induced and secondary pain, active range of motion, and proprioception in female office workers with chronic low back pain: a randomized controlled trial. Clinical rehabilitation. 2015;29(7):653-62.
13. May S, Donelson R. Evidence-informed management of chronic low back pain with the McKenzie method. The Spine Journal. 2008;8(1):134-41.
14. Clare HA, Adams R, Maher CG. A systematic review of efficacy of McKenzie therapy for spinal pain. Australian journal of Physiotherapy. 2004;50(4):209-16.
15. Clare HA, Adams R, Maher CG. Reliability of McKenzie classification of patients with cervical or lumbar pain. Journal of Manipulative and Physiological therapeutics. 2005;28(2):122-7.
16. Kilpikoski S, Airaksinen O, Kankaanpää M, Leminen P, Videman T, Alen M. Interexaminer reliability of low back pain assessment using the McKenzie method. Spine. 2002;27(8):E207-E14.
17. 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. LWW; 2011.
18. Long A, Donelson R, Fung T. Does it matter which exercise?: A randomized control trial of exercise for low back pain. LWW; 2004.
19. Albert HB, Manniche C. The efficacy of systematic active conservative treatment for patients with severe sciatica: a single-blind, randomized, clinical, controlled trial. LWW; 2012.
20. Pratama MAW, Bustamam N, Zulfa F. McKenzie exercise dan William’S flexion exercise efektif menurunkan intensitas low back pain. Jurnal Kesehatan Kusuma Husada. 2021:42-52.
21. Akbari A, Khorashadizadeh S, Abdi G. The effect of motor control exercise versus general exercise on lumbar local stabilizing muscles thickness: randomized controlled trial of patients with chronic low back pain. Journal of back and musculoskeletal rehabilitation. 2008;21(2):105-12.
22. Shamsi M, Sarrafzadeh J, Jamshidi A, Zarabi V, Pourahmadi MR. The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging. Physiotherapy theory and practice. 2016;32(4):277-83.
23. Hosseinifar M, Akbari M, Behtash H, Amiri M, Sarrafzadeh J. The effects of stabilization and McKenzie exercises on transverse abdominis and multifidus muscle thickness, pain, and disability: a randomized controlled trial in nonspecific chronic low back pain. Journal of physical therapy science. 2013;25(12):1541-5.
24. Tidstrand J, Horneij E. Inter-rater reliability of three standardized functional tests in patients with low back pain. BMC musculoskeletal disorders. 2009;10:1-8.
25. Kanagaraj R. A Comparative Study To Find Out The Effectiveness Between Core Stabilization Vs Mckenzie Exercises In The Treatment Of Patients With Mechanical Low Back Pain. International journal of creative research thoughts. 2021;9(6):1-8.
26. El-Bahrawy MN, Rehab NI, Farahat SAI. EFFECT OF LUMBAR STABILIZATION VERSUS MCKENZIE EXERCISES ON PAIN AND FUNCTIONAL DISABILITY IN PATIENTS WITH POST LAMINECTOMY SYNDROME: A RANDOMIZED CONTROLLED TRIAL. International journal of Recent advances in multidisciplinary research. 2019;06(06).
27. Fairbank JC. Oswestry disability index. Journal of Neurosurgery: Spine. 2014;20(2):239-42.
28. Halliday MH, Pappas E, Hancock MJ, Clare HA, Pinto RZ, Robertson G, et al. 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. Physiotherapy. 2019;105(4):442-5.
29. Arain SH, Abbasi MK, Bhatti SH, Naqvi ASAH, Ali A, Samdani I. A Comparative Study of McKenzie Back Program and Conventional Physiotherapy in Relieving Backache due to Lumbar Disc Prolapse. Journal of Pakistan Orthopaedic Association. 2021;33(02):76-80.
30. Khan M, Khan DA, Khan MI. EFFECTIVENESS OF MCKENZIE EXERCISES ON PAIN AND DISABILITY IN ACUTE DISCOGENIC SCIATICA. Annals of Allied Health Sciences. 2015;1(2):35-7.
31. Aqil F, Iqbal MA, Karim S, Iqbal MU, Akram MJ, Mehreen Z, et al. Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain. Rehman Journal of Health Sciences. 2021;3(1):24-31.
32. Manasa S. Effects of Lumbar Stabilization Exercises, Mckenzie Exercises and Conventional Exercises on Pain, Function and Range of Motion in Patients with Mechanical Low Back Pain: A Comparative study: KMCH College of Physiotherapy, Coimbatore; 2016.
33. Shayesteh Azar M, Talebpour F, Alaee A, Hadinejad A, Sajadi M, Nozari A. Association of low back pain with lumbar lordosis and lumbosacral angle. Journal of Mazandaran University of Medical Sciences. 2010;20(75):9-15.
34. Olivier TL, M SD, Mathew C-F, al E. Effectiveness of the Mckenzie method of mechanical diagnosis and therapy for treating low back pain;literature review with meta-analysis. Journal of Orthopaedic and Sports Physical Therapy. 2018;48.
2. Owen PJ, Miller CT, Mundell NL, Verswijveren SJ, Tagliaferri SD, Brisby H, et al. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British journal of sports medicine. 2020;54(21):1279-87.
3. Coulombe BJ, Games KE, Neil ER, Eberman LE. Core stability exercise versus general exercise for chronic low back pain. Journal of athletic training. 2017;52(1):71-2.
4. Lee J-Y, Lee D-Y. The effect of therapeutic abdominal drawing-in maneuver using ultrasonography on lateral abdominal muscle thickness and balance. Journal of Back and Musculoskeletal Rehabilitation. 2018;31(6):1139-43.
5. Hlaing SS, Puntumetakul R, Khine EE, Boucaut R. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC musculoskeletal disorders. 2021;22:1-13.
6. SA F. Effect Of Lumbar Stabilization Versus Mckenzie Exercises On Pain And Functional Disability In Patients With Post Laminectomy Syndrome: A Randomized Controlled Trial. International Journal of Recent Advances in Multidisciplinary Research. 2019;06(06):5.
7. Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, et al. Neck pain: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy. 2017;47(7):A1-A83.
8. Vleeming A, Schuenke M, Danneels L, Willard F. The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. Journal of anatomy. 2014;225(4):447-62.
9. Tsao H, Druitt TR, Schollum TM, Hodges PW. Motor training of the lumbar paraspinal muscles induces immediate changes in motor coordination in patients with recurrent low back pain. The journal of pain. 2010;11(11):1120-8.
10. Tsao H, Hodges PW. Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. Journal of electromyography and kinesiology. 2008;18(4):559-67.
11. Hoffman SL, Johnson MB, Zou D, Harris-Hayes M, Van Dillen LR. Effect of classification-specific treatment on lumbopelvic motion during hip rotation in people with low back pain. Manual therapy. 2011;16(4):344-50.
12. Kim TH, Kim E-H, Cho H-y. The effects of the CORE programme on pain at rest, movement-induced and secondary pain, active range of motion, and proprioception in female office workers with chronic low back pain: a randomized controlled trial. Clinical rehabilitation. 2015;29(7):653-62.
13. May S, Donelson R. Evidence-informed management of chronic low back pain with the McKenzie method. The Spine Journal. 2008;8(1):134-41.
14. Clare HA, Adams R, Maher CG. A systematic review of efficacy of McKenzie therapy for spinal pain. Australian journal of Physiotherapy. 2004;50(4):209-16.
15. Clare HA, Adams R, Maher CG. Reliability of McKenzie classification of patients with cervical or lumbar pain. Journal of Manipulative and Physiological therapeutics. 2005;28(2):122-7.
16. Kilpikoski S, Airaksinen O, Kankaanpää M, Leminen P, Videman T, Alen M. Interexaminer reliability of low back pain assessment using the McKenzie method. Spine. 2002;27(8):E207-E14.
17. 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. LWW; 2011.
18. Long A, Donelson R, Fung T. Does it matter which exercise?: A randomized control trial of exercise for low back pain. LWW; 2004.
19. Albert HB, Manniche C. The efficacy of systematic active conservative treatment for patients with severe sciatica: a single-blind, randomized, clinical, controlled trial. LWW; 2012.
20. Pratama MAW, Bustamam N, Zulfa F. McKenzie exercise dan William’S flexion exercise efektif menurunkan intensitas low back pain. Jurnal Kesehatan Kusuma Husada. 2021:42-52.
21. Akbari A, Khorashadizadeh S, Abdi G. The effect of motor control exercise versus general exercise on lumbar local stabilizing muscles thickness: randomized controlled trial of patients with chronic low back pain. Journal of back and musculoskeletal rehabilitation. 2008;21(2):105-12.
22. Shamsi M, Sarrafzadeh J, Jamshidi A, Zarabi V, Pourahmadi MR. The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging. Physiotherapy theory and practice. 2016;32(4):277-83.
23. Hosseinifar M, Akbari M, Behtash H, Amiri M, Sarrafzadeh J. The effects of stabilization and McKenzie exercises on transverse abdominis and multifidus muscle thickness, pain, and disability: a randomized controlled trial in nonspecific chronic low back pain. Journal of physical therapy science. 2013;25(12):1541-5.
24. Tidstrand J, Horneij E. Inter-rater reliability of three standardized functional tests in patients with low back pain. BMC musculoskeletal disorders. 2009;10:1-8.
25. Kanagaraj R. A Comparative Study To Find Out The Effectiveness Between Core Stabilization Vs Mckenzie Exercises In The Treatment Of Patients With Mechanical Low Back Pain. International journal of creative research thoughts. 2021;9(6):1-8.
26. El-Bahrawy MN, Rehab NI, Farahat SAI. EFFECT OF LUMBAR STABILIZATION VERSUS MCKENZIE EXERCISES ON PAIN AND FUNCTIONAL DISABILITY IN PATIENTS WITH POST LAMINECTOMY SYNDROME: A RANDOMIZED CONTROLLED TRIAL. International journal of Recent advances in multidisciplinary research. 2019;06(06).
27. Fairbank JC. Oswestry disability index. Journal of Neurosurgery: Spine. 2014;20(2):239-42.
28. Halliday MH, Pappas E, Hancock MJ, Clare HA, Pinto RZ, Robertson G, et al. 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. Physiotherapy. 2019;105(4):442-5.
29. Arain SH, Abbasi MK, Bhatti SH, Naqvi ASAH, Ali A, Samdani I. A Comparative Study of McKenzie Back Program and Conventional Physiotherapy in Relieving Backache due to Lumbar Disc Prolapse. Journal of Pakistan Orthopaedic Association. 2021;33(02):76-80.
30. Khan M, Khan DA, Khan MI. EFFECTIVENESS OF MCKENZIE EXERCISES ON PAIN AND DISABILITY IN ACUTE DISCOGENIC SCIATICA. Annals of Allied Health Sciences. 2015;1(2):35-7.
31. Aqil F, Iqbal MA, Karim S, Iqbal MU, Akram MJ, Mehreen Z, et al. Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain. Rehman Journal of Health Sciences. 2021;3(1):24-31.
32. Manasa S. Effects of Lumbar Stabilization Exercises, Mckenzie Exercises and Conventional Exercises on Pain, Function and Range of Motion in Patients with Mechanical Low Back Pain: A Comparative study: KMCH College of Physiotherapy, Coimbatore; 2016.
33. Shayesteh Azar M, Talebpour F, Alaee A, Hadinejad A, Sajadi M, Nozari A. Association of low back pain with lumbar lordosis and lumbosacral angle. Journal of Mazandaran University of Medical Sciences. 2010;20(75):9-15.
34. Olivier TL, M SD, Mathew C-F, al E. Effectiveness of the Mckenzie method of mechanical diagnosis and therapy for treating low back pain;literature review with meta-analysis. Journal of Orthopaedic and Sports Physical Therapy. 2018;48.
| Issue | Articles in Press | |
| Section | Research Article(s) | |
| Keywords | ||
| low back pain, Exercise therapy, Core stability, Range of motion | ||
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How to Cite
1.
Nemati H, Niknam H, Kalantari K, Baghban A, Jalili N. Effects of Core Stability and Mckenzie Exercises in Mechanical Non Specific low Back Pain with Extension Preference. jmr. 2024;(-).
