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National and International Guidelines that feature the McKenzie Method
These are primary research papers that illustrate the prognostic value of centralisation – most, though not all, studies relate to the lumbar spine.
These reviews use clearly defined strategies for searching the literature, explicit criteria for appraising the quality of papers reviewed, and a validated method of analysing those papers. They are considered the strongest form of evidence in the hierarchy of evidence to judge health care interventions.
These papers review aspects of treatment.
These are primary research papers following a group of patients through a particular intervention(s). Mostly these are randomised control trials, which are considered the strongest source of primary evidence about interventions. The trials either purport to use the McKenzie Method® or are relevant to some aspect of the approach; not all however use the method in its true form.
Included are general surveys of physical therapy practice, which include therapists’ use of the McKenzie Method®. Also, retrospective surveys of patients who have been treated with the McKenzie Method®.
These are primary research studies into the reliability and validity of McKenzie assessment, or aspects of it. Also included here are articles about classification of back pain, and descriptions of some techniques.
In vitro and in vivo studies looking at the effects of different mechanical loading. For instance, reviews of different postures, the effects of flexion/extension on intradiscal material, pain provocation studies etc.
Original material written by McKenzie and other authors that describe the method of assessment and treatment for both lumbar and cervical spines.
Papers in which the authors present a didactic analysis of some aspect of spinal care relevant to the McKenzie Method®.
These reviews use clearly defined strategies for searching the literature, explicit criteria for appraising the quality of papers reviewed, and a validated method of analysing those papers. They are considered the strongest form of evidence in the hierarchy of evidence to judge health care interventions.
These are primary research papers following a group of patients through a particular intervention(s). Mostly these are randomised control trials, which are considered the strongest source of primary evidence about interventions. The trials either purport to use the McKenzie Method® or are relevant to some aspect of the approach; not all however use the method in its true form.
These are primary research studies into the reliability and validity of McKenzie assessment, or aspects of it. Also included here are articles about classification of neck pain, and descriptions of some techniques.
In vitro and in vivo studies looking at the effects of different mechanical loading. For instance, reviews of different postures, the effects of flexion/extension on intradiscal material, pain provocation studies etc.
These papers review aspects of treatment.
These are primary research papers following a group of patients through a particular intervention(s). Mostly these are randomised control trials, which are considered the strongest source of primary evidence about interventions. The trials either purport to use the McKenzie Method® or are relevant to some aspect of the approach; not all however use the method in its true form.
Letters concerning some of the previous articles (lumbar and cervical).
Papers that are relevant to use of MDT in non-spinal areas.
Qualitative studies that are relevant to the McKenzie method.
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  Broez D, Burkard S, Weller M ; A prospective study of mechanical physiotherapy for lumbar disk prolapse: five year follow-up and final report. NeuroRehab; 26.155-158, 2010.
Follow-up of previous study in which patients with lumbar herniations and demonstrating centralisation predicted good long-term outcome in the majority of patients.
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| Lumbar: Systematic Reviews |
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Choi BKL, Verbeek JH, Tam WWS, Jiang JY; Exercises for prevention of recurrences of low-back pain Cochrane Library; Cochrane Library 2010, Issue 3. www.thecochraneibrary.com, 2010.
13 articles were included in the review, 2 of which involved McKenzie exercises. Overall there was moderate quality evidence that exercises were effective at reducing recurrences at one year and the number of recurrences; but no evidence of difference between McKenzie and back pain education.
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| Lumbar: Reviews |
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Kamper SJ, Maher CG, Hancock MJ, Koes BW, Croft PE, Hay E; Treatment-based subgroups of low back pain: a guide to appraisal of research studies and a summary of current evidence. Best Pract Res Clin Rheum; 24.181-191., 2010.
Outline of key concepts related to sub-groups of back pain, and summary of current evidence. A 3-stage process is suggested as being necessary: 1) hypothesis generation to define sub-groups; 2) a randomised controlled trial to test that sub-group membership improves outcomes; 3) replication of stage 2. They concluded that all classification systems have not developed beyond first stage.
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Lederman E; The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. CPDO Online J; March 1-14, 2010.
Review article that challenges the links between postural-structural-biomechanical factors and the presence of back pain. With a review of literature relating to the absence of a link between asymmetries, degenerative changes, postural factors, and motor control variations and back pain. Furthermore the body has plenty of surplus capacity to cope with these minor variations without symptoms.
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| Lumbar: Trials |
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Chen J, Philips Amy, Ramsey M, Schenk R. ; A case study examining the effectiveness of Mechanical Diagnosis and Therapy in a patient who met the clinical prediction rule for spinal manipulation. J Man Manip Thera; 17.216-220, 2010.
Case study of patient who met 4/5 of clinical prediction rule for manipulation criteria who failed to respond to 2 sessions of manipulation, but then responded to repeated movements.
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Gagne AR, Hasson SM; Lumbar extension exercises in conjunction with mechanical traction for the management of a patient with a lumbar herniated disc. Physio Theory & Pract; 256-266, 2010.
Case study of patient showing some improvement with extension exercises and greater improvement when combined with traction over 14 sessions of treatment.
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Machado LAC, Maher CG, Herbert RD, Clare H, McAuley JH; The effectiveness of the McKenzie method in addition to first-line care for acute low back pain: a randomized controlled trial. BMC Med; 8:10, 2010.
Comparison of trained GP care (advice, reassurance, and paracetamol) with trained GP care plus McKenzie care delivered by therapists with credentialed qualification over 3 weeks. There were significant differences favouring the McKenzie group in pain over the first few weeks, though these differences were clinically small, but there were no significant differences in perceived effect, function or persistent symptoms. Patients in the McKenzie group sought significantly less additional care.
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| Lumbar: Anatomical & physiological studies |
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Beattie PF, Arnot CF, Donley JW, Noda H, Bailey L ; The immediate reduction in low back pain intensity following lumbar joint mobilization and prone press-ups is associated with increased diffusion of water in the L5-S! intervertebral disc. JOSPT; 40.256-264, 2010.
20 patients with back pain who received extension mobilizations and extension in lying were monitored with MRI before and after, and classified as responders if there was a reduction in pain score of 2 or more. Responders demonstrated a mean increase in diffusion coefficient in the middle portion of the disc compared to a mean decrease in the non-responders.
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Fazey PJ, Takasaki H, Singer KP; Nucleus pulposus deformation in response to lumbar spine lateral flexion: an in vivo MRI investigation. Eur Spine J; DOI 10.1007/s00586-010-1339-4, 2010.
A novel MRI method derived from pixels and the effect lateral flexion is described; in 95% of healthy subjects the nucleus pulposus was displaced away from the direction of lateral flexion.
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| Textbooks, Chapters and Overviews of MDT |
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Sagi G; Process to clinically identify a directional preference in patients suffering from spinal mechanical pain with the McKenzie method. Kines Rev; 99.17-23, 2010.
Summary of how therapists can find clues for directional preference in the history and confirm these on physical examination (in French).
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