Efficacy of McKenzie Manipulative Therapy on Pain, Functional Activity and Disability for Lumbar Disc Herniation



Mohammad Anwar Hossain1, 2, Iqbal Kabir Jahid2, Md. Forhad Hossain3, Zakir Uddin4, *, Md. Feroz Kabir5, K. M. Amran Hossain1, Md. Nazmul Hassan6, Lori Walton7
1 Department of Physiotherapy, Bangladesh Health Professions Institute, Savar Union, Bangladesh
2 Department of Microbiology, Jashore University of Science & Technology, Churamonkathi, Bangladesh
3 Department of Statistics, Jahangirnagar University, Savar Union, Bangladesh
4 McMaster University, School of Rehabilitation Science, Saskatoon, Canada
5 Department of Physiotherapy & Rehabilitation, Jashore University of Science & Technology, Churamonkathi, Bangladesh
6 Department of Physiotherapy, Centre for the Rehabilitation of the Paralysed (CRP), Dhaka, Bangladesh
7 Department of Physical Therapy, University of Scranton, Pennsylvania, USA


© 2021 Hossain. et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at McMaster University, School of Rehabilitation Science, Saskatoon, Canada; E-mails: zakiru@gmail.com; uddinz2@mcmaster.ca


Abstract

Introduction:

Lumbar disc herniation (LDH) is a common determinant of low back pain (LBP) and priority for cost-effective therapeutic approach is necessary. The objective of the study was to explore the effectiveness of McKenzie Manipulative Therapy (MMT) for patients with LDH.

Methodology:

This was an assessor blinded, 36-month RCT, at Center for Rehabilitation of the Paralyzed (CRP) in Savaar, Bangladesh. Seventy-two subjects, ages 28-47 years and clinically diagnosed with MRI findings of LDH, were randomly recruited from hospital records and sixty-eight found eligible. The control group received stretching exercise and graded oscillatory mobilization, and the experimental group received McKenzie manipulative therapy for 12 sessions in 4 weeks, both groups received a standard set of care also. The pain was the primary outcome and the secondary outcome was participation in functional activities and disability.

Results:

Pain and Disability found significant improvement in both groups, with the McKenzie approach significantly superior to the control group (p<.05). Bothersome in Activities (SBI) reported significantly lower post report compared to baseline for both groups (p<.01). McKenzie showed significantly superior outcomes for fear avoidance (FABQ) total and SBI feeling of abnormal sensation in leg compared to the control group (p <.05).

Conclusion:

The McKenzie manipulative therapy approach was found to be effective for pain, disability and participation in activities for single or multiple level LDH patients in a short time from day 1 to week 4, and the treatment effect extends after 6 months.

Clinical Trial Registration No.: CTRI/2020/ 04/024667.

Keywords: Herniated Disc, Sciatica, Manual Therapy, Manipulative Therapies, Rehabilitation, RCT.