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McKenzie method

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McKenzie method
Robin Anthony McKenzie
Other namesMechanical diagnosis and therapy

The McKenzie method (full name: McKenzie method of mechanical diagnosis and therapy (MDT)) is a technique primarily used in physical therapy. It was developed in the late 1950s by New Zealand physical therapist Robin McKenzie (1931–2013).[1][2][3] In 1981 he launched the concept which he called Mechanical Diagnosis and Therapy (MDT) – a system encompassing assessment, diagnosis and treatment for the spine and extremities. MDT categorises patients' complaints not on an anatomical basis,[4][5][6] but subgroups them by the clinical presentation of patients.[7]

McKenzie exercises involve spinal extension exercises, as opposed to William flexion exercises, which involve lumbar flexion exercises.

However some publication question high effectiveness of the method it's important to notice that the value of it is mostly in pointing to reasons why such chronic or acute pain occurred. Without fully understanding this relation between deformation of the soft tissue under pressure and pain sometimes projected on others body area is difficult to achieve expected improvement. So, the key part of the therapy is explanation of the cause and effect and experiment on patient soft tissue how pain is generated.

History

The McKenzie method has its roots in an event in 1956 that led to increased experimentation of certain movement in order to elicit what McKenzie method practitioners call the centralisation phenomenon—pain moving towards the spine. A patient who was experiencing pain lay down on McKenzie's treatment table. After bending backward for five minutes the patient experienced noted improvement.[8] This led McKenzie to experiment with specific movement patterns to treat chronic lower back pain and bring about centralisation of pain symptoms. McKenzie later developed a classification system to categorise spinal pain problems, and published books on the topic, including Treat Your Own Back (1980).[9][10][11][12]

The McKenzie method was commonly used worldwide in the late 2000s in diagnosis[13] and treatment of low back pain,[14][15][16][17] and peripheral joint complaints.[18][19]

Centralisation

Centralisation occurs when pain symptoms off-centered from the mid-line of the spine emigrate towards the centre of the mid-line of the spine. This migration of pain symptoms to the centre of the lower back is a sign of progress in the McKenzie method. Extension exercises are sometimes referred to as McKenzie exercises for this reason.[8] According to the McKenzie method, movements and exercises that produce centralisation are beneficial whereas movements that move pain away from the spinal mid-line are detrimental.

See also

References

  1. ^ "Robin Anthony McKenzie". Archived from the original on 16 May 2013. Retrieved 15 May 2013.
  2. ^ McKenzie, Robin; May, Stephen (2006). Cervical and Thoracic Spine: Mechanical Diagnosis and Therapy. Orthopedic Physical Therapy Products. ISBN 978-0-9583647-7-5.[page needed]
  3. ^ McKenzie, Robin A.; May, Stephen (2003). The lumbar spine mechanical diagnosis & therapy. Waikanae: Spinal Publications New Zealand. ISBN 978-0-9583647-5-1.[page needed]
  4. ^ Young, S; April, C; Laslett, M (2003). "Correlation of clinical examination characteristics with three sources of chronic low back pain". The Spine Journal. 3 (6): 460–5. doi:10.1016/S1529-9430(03)00151-7. PMID 14609690.
  5. ^ Hancock, M. J.; Maher, C. G.; Latimer, J.; Spindler, M. F.; McAuley, J. H.; Laslett, M.; Bogduk, N. (2007). "Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain". European Spine Journal. 16 (10): 1539–1550. doi:10.1007/s00586-007-0391-1. PMC 2078309. PMID 17566796.
  6. ^ Kolber, Morey J.; Hanney, William J. (2009). "The dynamic disc model: a systematic review of the literature". Physical Therapy Reviews. 14 (3): 181–19. doi:10.1179/174328809X452827.
  7. ^ Werneke, Mark W.; Hart, Dennis L. (2004). "Categorizing patients with occupational low back pain by use of the Quebec Task Force Classification system versus pain pattern classification procedures: discriminant and predictive validity". Physical Therapy. 84 (3): 243–54. PMID 14984296. Archived from the original on 10 September 2012.
  8. ^ a b McKenzie, Robin (2011). Treat Your Own Back. Spinal Publications New Zealand Ltd. pp. x–xi. ISBN 978-0-9876504-0-5.
  9. ^ McKenzie RA. The lumbar spine: mechanical diagnosis and therapy. Waikanae, NZ: Spinal Publications New Zealand Ltd., 1981.
  10. ^ Udermann, B; Spratt, KF; Donelson, RG; Mayer, J; Graves, JE; Tillotson, J (2004). "Can a patient educational book change behavior and reduce pain in chronic low back pain patients?". The Spine Journal. 4 (4): 425–35. doi:10.1016/j.spinee.2004.01.016. PMID 15246305.
  11. ^ May, S; Donelson, R (2008). "Evidence-informed management of chronic low back pain with the McKenzie method". The Spine Journal. 8 (1): 134–41. doi:10.1016/j.spinee.2007.10.017. PMID 18164461.
  12. ^ May, S; Gardiner, E; Young, S; Klaber-Moffett, J (2008). "Predictor Variables for a Positive Long-Term Outcome in Patients with Acute and Chronic Neck and Back Pain Treated with a McKenzie Approach: A Secondary Analysis". The Journal of Manual & Manipulative Therapy. 16 (3): 155–60. doi:10.1179/jmt.2008.16.3.155. PMC 2582422. PMID 19119405.
  13. ^ Horton, S; Franz, A (2007). "Mechanical Diagnosis and Therapy approach to assessment and treatment of derangement of the sacro-iliac joint". Manual Therapy. 12 (2): 126–32. doi:10.1016/j.math.2006.06.001. PMID 16891145.
  14. ^ Spoto, Marcia Miller; Collins, Jennifer (2008). "Physiotherapy diagnosis in clinical practice: a survey of orthopaedic certified specialists in the USA". Physiotherapy Research International. 13 (1): 31–41. doi:10.1002/pri.390. PMID 18189334.
  15. ^ Miller, Eric R.; Schenk, Ronald J.; Karnes, James L.; Rousselle, John G. (2005). "A Comparison of the McKenzie Approach to a Specific Spine Stabilization Program for Chronic Low Back Pain". Journal of Manual & Manipulative Therapy. 13 (2): 103–12. doi:10.1179/106698105790824996.
  16. ^ Tulder, Maurits; Becker, Annette; Bekkering, Trudy; Breen, Alan; Gil Del Real, Maria Teresa; Hutchinson, Allen; Koes, Bart; Laerum, Even; et al. (2006). "Chapter 3 European guidelines for the management of acute nonspecific low back pain in primary care". European Spine Journal. 15: S169–91. doi:10.1007/s00586-006-1071-2. PMC 3454540. PMID 16550447.{{cite journal}}: CS1 maint: numeric names: authors list (link)
  17. ^ Schrupp, Robert J. (June 2004). "Honoring Our 'Giants'". Advance for Physical Therapy & Rehab Medicine. 15 (14): 61. Archived from the original on 7 July 2011. Retrieved 7 December 2010.
  18. ^ May, Stephen; Ross, Jenny (2009). "The McKenzie Classification System in the Extremities: A Reliability Study Using Mckenzie Assessment Forms and Experienced Clinicians". Journal of Manipulative and Physiological Therapeutics. 32 (7): 556–63. doi:10.1016/j.jmpt.2009.08.007. PMID 19748407.
  19. ^ McKenzie, Robin (2000). Human Extremities: Mechanical Diagnosis and Therapy. Orthopedic Physical Therapy Products. ISBN 978-0-9583647-0-6.[page needed]
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