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Objective: To compare the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) exercise program to other treatment modalities for reducing pain, disability, and improving function in patients complaining of low back pain. Design: Systematic literature review. Methods: Searches were conducted in PubMed and Google Scholar using terms “McKenzie Method”, “mechanical diagnosis and therapy”, “low back pain”, “spinal manipulation”, “physical therapy”, and “placebo”. Results: In Machado et al., a statistically significant difference was found between MDT and using a first line approach (advice, reassurance, and over the counter (OTC) analgesics) regarding pain; however, it did not meet the pre-established level of clinical importance. In Peterson et al., improvement in disability was greater in the MDT group compared to the spinal manipulation group; additionally, MDT had better adherence and completion of therapy than spinal manipulation. In Paatelma et al., there was no statistical significance between MDT and the orthopedic manual therapy group. However, there was statistical significance between MDT and the advice only group at 12 months for improvement in pain.Conclusion: Statistical significance was present in some outcomes; however, clinical significance was low when comparing MDT to other treatment modalities. Patients who received MDT had a perceived improvement in their LBP. Most LBP in an acute episode will resolve with or without treatment. Further review is warranted to measure both long term outcomes (greater than 1 year) of LBP with MDT intervention and utilizing studies with a more uniformed methodology of conducting research.
Harrison DE, Meyer SJ. The McKenzie Method and Treatment of Low Back Pain. JMU Scholarly Commons Physician Assistant Capstones. https://commons.lib.jmu.edu/pacapstones/37/. Published December 12, 2018.