The McKenzie Method versus guideline-based advice in the treatment of sciatica : 24-month outcomes of a randomised clinical trial
Abstract
Objective
To compare the effectiveness of a McKenzie Method intervention in patients with sciatica with guideline-based patient education.
Design
Multi-centre, assessor-blinded, parallel-group, randomised trial
Setting
Two tertiary hospitals providing operative spinal care.
Subjects
Sciatica patients with magnetic resonance imaging-confirmed lumbar disc herniation compressing a nerve root.
Interventions
The McKenzie group received specific back exercises for seven visits combined with an educational book, and the Control group received a single session of self-management guidance according to usual practices.
Main measures
The primary outcome was the number of surgical operations. Secondary outcomes were pain measured using the Visual Analogue Scale, disability using the Oswestry Disability Index and health-related quality of life using a RAND-36 questionnaire at baseline and 24-month follow-up.
Results
Altogether 66 patients, mean age of 43 years, of which 50% were females with long-lasting sciatica, mean 16 weeks, were randomised to two groups. Nineteen patients (29%) had surgery. There was no significant difference in surgery rates between the groups. Back and leg pain decreased, and disability improved in both groups. Health-related quality of life improved in six dimensions out of eight in both groups. There were no significant between-group changes in the patient-reported outcomes at the follow-up.
Conclusions
Multiple sessions of McKenzie-based back exercises with a McKenzie-specific patient's educational book produced effects equal to guideline-based advice at long-term follow-up. However, the power of these results is diminished due to the small patient population and confounding factors.
Main Authors
Format
Articles
Research article
Published
2024
Series
Subjects
Publication in research information system
Publisher
SAGE Publications
The permanent address of the publication
https://urn.fi/URN:NBN:fi:jyu-202501301661Use this for linking
Review status
Peer reviewed
ISSN
0269-2155
DOI
https://doi.org/10.1177/02692155231196393
Language
English
Published in
Clinical Rehabilitation
Citation
- Kilpikoski, S., Häkkinen, A. H., Repo, J. P., Kyrölä, K., Multanen, J., Kankaanpää, M., Vainionpää, A., Takala, E.-P., Kautiainen, H., & Ylinen, J. (2024). The McKenzie Method versus guideline-based advice in the treatment of sciatica : 24-month outcomes of a randomised clinical trial. Clinical Rehabilitation, 38(1), 72-84. https://doi.org/10.1177/02692155231196393
Additional information about funding
This work was supported by the Jenny ja Antti Wihurin Rahasto (grant number 07.10.2015).
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