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Mark J Hancock - One of the best experts on this subject based on the ideXlab platform.

  • 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
    2019
    Co-Authors: Helen Clare, Mark J Hancock, Mark H Halliday, Evangelos Pappas, Rafael Z Pinto, Gavin Robertson, Paulo H Ferreira
    Abstract:

    Abstract Objective The 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. Design Randomized controlled trial. Setting A secondary public health facility in Sydney, Australia. Participants Seventy adults with greater than 3-month history of LBP and a directional preference. Interventions Participants were randomized to receive 12 treatments of either the McKenzie Method or motor control exercises over 8-weeks. Outcome measures Muscle 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. Results Fifty-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. Conclusion Trunk 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.

  • 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 a randomised placebo controlled trial with short and longer term follow up
    2018
    Co-Authors: Alessandra N Garcia, Luciola Da Cunha Menezes Costa, Mark J Hancock, Matheus Oliveira De Almeida, Fabricio Soares De Souza, Georgia Vieira Freschi De Oliveira Gomes, Leonardo Oliveira Pena Costa
    Abstract:

    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. Trial registration number ClinicalTrials.gov (NCT02123394)

  • effectiveness of McKenzie Method based self management approach for the secondary prevention of a recurrence of low back pain safe trial protocol for a pragmatic randomized controlled trial
    2017
    Co-Authors: Tarcisio F De Campos, Christopher G Maher, Helen Clare, Tatiane Da Silva, Mark J Hancock
    Abstract:

    Background Although many people recover quickly from an episode of low back pain (LBP), recurrence is very common. There is limited evidence on effective prevention strategies for recurrences of LBP. Objective The purpose of this study was to determine the effectiveness of a McKenzie Method-based self-management approach in the secondary prevention of LBP. Design This will be a pragmatic randomized controlled trial. Setting Participants will be recruited from the community and primary care, with the intervention delivered in a number of physical therapist practices in Sydney, Australia. Participants The study will have 396 participants, all of whom are at least 18 years old. Intervention Participants will be randomly assigned to either the McKenzie Method-based self-management approach group or a minimal intervention control group. Measurements The primary outcome will be days to first self-reported recurrence of an episode of activity-limiting LBP. The secondary outcomes will include: days to first self-reported recurrence of an episode of LBP, days to first self-reported recurrence of an episode of LBP leading to care seeking, and the impact of LBP over a 12-month period. All participants will be followed up monthly for a minimum of 12 months or until they have a recurrence of activity-limiting LBP. All participants will also be followed-up at 3, 6, 9, and 12 months to assess the impact of back pain, physical activity levels, study program adherence, credibility, and adverse events. Limitations Participants and therapists will not be masked to the interventions. Conclusions To our knowledge, this will be the first large, high-quality randomized controlled trial investigating the effectiveness of a McKenzie Method-based self-management approach for preventing recurrences of LBP. If this approach is found to be effective, it will offer a low-cost, simple Method for reducing the personal and societal burdens of LBP.

  • a randomized controlled trial comparing the McKenzie Method to motor control exercises in people with chronic low back pain and a directional preference
    2016
    Co-Authors: Helen Clare, Mark J Hancock, Mark H Halliday, Evangelos Pappas, Rafael Z Pinto, Gavin Robertson, Paulo H Ferreira
    Abstract:

    Study Design Randomized clinical trial. Background Motor control exercises are believed to improve coordination of the trunk muscles. It is unclear whether increases in trunk muscle thickness can be facilitated by approaches such as the McKenzie Method. Furthermore, it is unclear which approach may have superior clinical outcomes. Objectives The primary aim was to compare the effects of the McKenzie Method and motor control exercises on trunk muscle recruitment in people with chronic low back pain classified with a directional preference. The secondary aim was to conduct a between-group comparison of outcomes for pain, function, and global perceived effect. Methods Seventy people with chronic low back pain who demonstrated a directional preference using the McKenzie assessment were randomized to receive 12 treatments over 8 weeks with the McKenzie Method or with motor control approaches. All outcomes were collected at baseline and at 8-week follow-up by blinded assessors. Results No significant between-gr...

  • efficacy of the McKenzie Method in patients with chronic nonspecific low back pain a protocol of randomized placebo controlled trial
    2015
    Co-Authors: Alessandra N Garcia, Luciola Da Cunha Menezes Costa, Mark J Hancock, Matheus Oliveira De Almeida, Fabricio Soares De Souza, Leonardo Oliveira Pena Costa
    Abstract:

    Background The McKenzie Method is widely used as an active intervention in the treatment of patients with nonspecific low back pain. Although the McKenzie Method has been compared with several other interventions, it is not yet known whether this Method is superior to placebo in patients with chronic low back pain. Objective The purpose of this trial is to assess the efficacy of the McKenzie Method in patients with chronic nonspecific low back pain. Design An assessor-blinded, 2-arm, randomized placebo-controlled trial will be conducted. Setting This study will be conducted in physical therapy clinics in Sao Paulo, Brazil. Participants The participants will be 148 patients seeking care for chronic nonspecific low back pain. Intervention Participants will be randomly allocated to 1 of 2 treatment groups: (1) McKenzie Method or (2) placebo therapy (detuned ultrasound and shortwave therapy). Each group will receive 10 sessions of 30 minutes each (2 sessions per week over 5 weeks). Measurements The clinical outcomes will be obtained at the completion of treatment (5 weeks) and at 3, 6, and 12 months after randomization. The primary outcomes will be pain intensity (measured with the Pain Numerical Rating Scale) and disability (measured with the Roland-Morris Disability Questionnaire) at the completion of treatment. The secondary outcomes will be pain intensity; disability and function; kinesiophobia and global perceived effect at 3, 6, and 12 months after randomization; and kinesiophobia and global perceived effect at completion of treatment. The data will be collected by a blinded assessor. Limitations Therapists will not be blinded. Conclusions This will be the first trial to compare the McKenzie Method with placebo therapy in patients with chronic nonspecific low back pain. The results of this study will contribute to better management of this population.

Leonardo Oliveira Pena Costa - One of the best experts on this subject based on the ideXlab platform.

  • 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 a randomised placebo controlled trial with short and longer term follow up
    2018
    Co-Authors: Alessandra N Garcia, Luciola Da Cunha Menezes Costa, Mark J Hancock, Matheus Oliveira De Almeida, Fabricio Soares De Souza, Georgia Vieira Freschi De Oliveira Gomes, Leonardo Oliveira Pena Costa
    Abstract:

    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. Trial registration number ClinicalTrials.gov (NCT02123394)

  • efficacy of the McKenzie Method in patients with chronic nonspecific low back pain a protocol of randomized placebo controlled trial
    2015
    Co-Authors: Alessandra N Garcia, Luciola Da Cunha Menezes Costa, Mark J Hancock, Matheus Oliveira De Almeida, Fabricio Soares De Souza, Leonardo Oliveira Pena Costa
    Abstract:

    Background The McKenzie Method is widely used as an active intervention in the treatment of patients with nonspecific low back pain. Although the McKenzie Method has been compared with several other interventions, it is not yet known whether this Method is superior to placebo in patients with chronic low back pain. Objective The purpose of this trial is to assess the efficacy of the McKenzie Method in patients with chronic nonspecific low back pain. Design An assessor-blinded, 2-arm, randomized placebo-controlled trial will be conducted. Setting This study will be conducted in physical therapy clinics in Sao Paulo, Brazil. Participants The participants will be 148 patients seeking care for chronic nonspecific low back pain. Intervention Participants will be randomly allocated to 1 of 2 treatment groups: (1) McKenzie Method or (2) placebo therapy (detuned ultrasound and shortwave therapy). Each group will receive 10 sessions of 30 minutes each (2 sessions per week over 5 weeks). Measurements The clinical outcomes will be obtained at the completion of treatment (5 weeks) and at 3, 6, and 12 months after randomization. The primary outcomes will be pain intensity (measured with the Pain Numerical Rating Scale) and disability (measured with the Roland-Morris Disability Questionnaire) at the completion of treatment. The secondary outcomes will be pain intensity; disability and function; kinesiophobia and global perceived effect at 3, 6, and 12 months after randomization; and kinesiophobia and global perceived effect at completion of treatment. The data will be collected by a blinded assessor. Limitations Therapists will not be blinded. Conclusions This will be the first trial to compare the McKenzie Method with placebo therapy in patients with chronic nonspecific low back pain. The results of this study will contribute to better management of this population.

Christopher G Maher - One of the best experts on this subject based on the ideXlab platform.

  • effectiveness of McKenzie Method based self management approach for the secondary prevention of a recurrence of low back pain safe trial protocol for a pragmatic randomized controlled trial
    2017
    Co-Authors: Tarcisio F De Campos, Christopher G Maher, Helen Clare, Tatiane Da Silva, Mark J Hancock
    Abstract:

    Background Although many people recover quickly from an episode of low back pain (LBP), recurrence is very common. There is limited evidence on effective prevention strategies for recurrences of LBP. Objective The purpose of this study was to determine the effectiveness of a McKenzie Method-based self-management approach in the secondary prevention of LBP. Design This will be a pragmatic randomized controlled trial. Setting Participants will be recruited from the community and primary care, with the intervention delivered in a number of physical therapist practices in Sydney, Australia. Participants The study will have 396 participants, all of whom are at least 18 years old. Intervention Participants will be randomly assigned to either the McKenzie Method-based self-management approach group or a minimal intervention control group. Measurements The primary outcome will be days to first self-reported recurrence of an episode of activity-limiting LBP. The secondary outcomes will include: days to first self-reported recurrence of an episode of LBP, days to first self-reported recurrence of an episode of LBP leading to care seeking, and the impact of LBP over a 12-month period. All participants will be followed up monthly for a minimum of 12 months or until they have a recurrence of activity-limiting LBP. All participants will also be followed-up at 3, 6, 9, and 12 months to assess the impact of back pain, physical activity levels, study program adherence, credibility, and adverse events. Limitations Participants and therapists will not be masked to the interventions. Conclusions To our knowledge, this will be the first large, high-quality randomized controlled trial investigating the effectiveness of a McKenzie Method-based self-management approach for preventing recurrences of LBP. If this approach is found to be effective, it will offer a low-cost, simple Method for reducing the personal and societal burdens of LBP.

  • can we predict response to the McKenzie Method in patients with acute low back pain a secondary analysis of a randomized controlled trial
    2012
    Co-Authors: Charles Sheets, Luciana A C Machado, Mark J Hancock, Christopher G Maher
    Abstract:

    Purpose To evaluate whether patients’ treatment preferences, characteristics, or symptomatic response to assessment moderated the effect of the McKenzie Method for acute low back pain (LBP).

  • the effectiveness of the McKenzie Method in addition to first line care for acute low back pain a randomized controlled trial
    2010
    Co-Authors: Luciana A C Machado, Christopher G Maher, Robert D Herbert, Helen Clare, James H Mcauley
    Abstract:

    Background Low back pain is a highly prevalent and disabling condition worldwide. Clinical guidelines for the management of patients with acute low back pain recommend first-line treatment consisting of advice, reassurance and simple analgesics. Exercise is also commonly prescribed to these patients. The primary aim of this study was to evaluate the short-term effect of adding the McKenzie Method to the first-line care of patients with acute low back pain.

  • the McKenzie Method for the management of acute non specific low back pain design of a randomised controlled trial actrn012605000032651
    2005
    Co-Authors: Luciana A C Machado, Christopher G Maher, Robert D Herbert, Helen Clare, James H Mcauley
    Abstract:

    Background Low back pain (LBP) is a major health problem. Effective treatment of acute LBP is important because it prevents patients from developing chronic LBP, the stage of LBP that requires costly and more complex treatment. Physiotherapists commonly use a system of diagnosis and exercise prescription called the McKenzie Method to manage patients with LBP. However, there is insufficient evidence to support the use of the McKenzie Method for these patients. We have designed a randomised controlled trial to evaluate whether the addition of the McKenzie Method to general practitioner care results in better outcomes than general practitioner care alone for patients with acute LBP.

Luciana A C Machado - One of the best experts on this subject based on the ideXlab platform.

  • can we predict response to the McKenzie Method in patients with acute low back pain a secondary analysis of a randomized controlled trial
    2012
    Co-Authors: Charles Sheets, Luciana A C Machado, Mark J Hancock, Christopher G Maher
    Abstract:

    Purpose To evaluate whether patients’ treatment preferences, characteristics, or symptomatic response to assessment moderated the effect of the McKenzie Method for acute low back pain (LBP).

  • the effectiveness of the McKenzie Method in addition to first line care for acute low back pain a randomized controlled trial
    2010
    Co-Authors: Luciana A C Machado, Christopher G Maher, Robert D Herbert, Helen Clare, James H Mcauley
    Abstract:

    Background Low back pain is a highly prevalent and disabling condition worldwide. Clinical guidelines for the management of patients with acute low back pain recommend first-line treatment consisting of advice, reassurance and simple analgesics. Exercise is also commonly prescribed to these patients. The primary aim of this study was to evaluate the short-term effect of adding the McKenzie Method to the first-line care of patients with acute low back pain.

  • the McKenzie Method for low back pain a systematic review of the literature with a meta analysis approach
    2006
    Co-Authors: Luciana A C Machado, Paulo H Ferreira, Manuela L Ferreira
    Abstract:

    STUDY DESIGN AND OBJECTIVES Meta-analysis of randomized controlled trials to evaluate the effectiveness of the McKenzie Method for low back pain (LBP). SUMMARY OF BACKGROUND DATA The McKenzie Method is a popular classification-based treatment for LBP. The faulty equation of McKenzie to extension exercises (generic McKenzie) is common in randomized trials. MethodS MEDLINE, EMBASE, PEDro, and LILACS were searched up to August 2003. Two independent reviewers extracted the data and assessed Methodologic quality. Pooled effects were calculated among homogeneous trials using the random effects model. A sensitivity analysis excluded trials reporting on generic McKenzie. RESULTS Eleven trials of mostly high quality were included. McKenzie reduced pain (weighted mean difference [WMD] on a 0- to 100-point scale, -4.16 points; 95% confidence interval, -7.12 to -1.20) and disability (WMD on a 0- to 100-point scale, -5.22 points; 95% confidence interval, -8.28 to -2.16) at 1 week follow-up when compared with passive therapy for acute LBP. When McKenzie was compared with advice to stay active, a reduction in disability favored advice (WMD on a 0- to 100-point scale, 3.85 points; 95% confidence interval, 0.30 to 7.39) at 12 weeks of follow-up. Heterogeneity prevented pooling of studies on chronic LBP as well as pooling of studies included in the sensitivity analysis. CONCLUSIONS There is some evidence that the McKenzie Method is more effective than passive therapy for acute LBP; however, the magnitude of the difference suggests the absence of clinically worthwhile effects. There is limited evidence for the use of McKenzie Method in chronic LBP. The effectiveness of classification-based McKenzie is yet to be established.

  • the McKenzie Method for the management of acute non specific low back pain design of a randomised controlled trial actrn012605000032651
    2005
    Co-Authors: Luciana A C Machado, Christopher G Maher, Robert D Herbert, Helen Clare, James H Mcauley
    Abstract:

    Background Low back pain (LBP) is a major health problem. Effective treatment of acute LBP is important because it prevents patients from developing chronic LBP, the stage of LBP that requires costly and more complex treatment. Physiotherapists commonly use a system of diagnosis and exercise prescription called the McKenzie Method to manage patients with LBP. However, there is insufficient evidence to support the use of the McKenzie Method for these patients. We have designed a randomised controlled trial to evaluate whether the addition of the McKenzie Method to general practitioner care results in better outcomes than general practitioner care alone for patients with acute LBP.

James H Mcauley - One of the best experts on this subject based on the ideXlab platform.