COMPARISON BETWEEN MCKENZIE EXTENSION AND NECK ISOMETRIC EXERCISES IN THE MANAGEMENT OF NONSPECIFIC NECK PAIN: A RANDOMIZED CONTROLLED TRIAL
Article Sidebar
Main Article Content
Abstract
OBJECTIVE: To compare the effects of neck exercises (McKenzie extension and isometric exercises) in the management of non-specific neck pain and range of motion in patients with neck pain.
METHODS: This randomized controlled trial was conducted in physiotherapy departments of Dr. Akbar Niazi Teaching Hospital, Islamabad. Forty consecutive patients with acute to sub-acute cases of neck pain (<3 month) were enrolled. Based on lottery method two groups (n=20 in each group) were differentiated, Group-I (control) received isometric neck exercises and Group-II (treatment) received McKenzie extension exercises for 4-weeks along with hot packs therapy. Neck pain was measured using numeric pain rating scale (NPRS). All patients were tested on baseline, at 2nd and 4th week.
RESULTS: Mean age of the sample was 33.85±4.80 and 33.50±5.20 years in group-I and group-II respectively. Male to female ratio was 4:1 in both groups. Mean body mass index was 24.54±1.50kg/m2. NPRS at baseline was 5.80±0.41 in group-I while 6.10±0.64 in group-II (p-value=0.001). NPRS decreased to 3.75±0.72 in group-I and 3.00±0.73 in group-II after 4-weeks (p-value=0.001). Neck flexion (degrees) at baseline was 31±2.05 in group-I and 35.75±1.83 in group-II (p-value=0.001) while after 4weeks increased to 35.50±4.26 in group-I and 40±4.29 in group-II (p-value=0.002). Neck extension (degrees) at baseline was 44±2.05 in group-I and 40.75±1.83 in group-II (p-value=0.001) while after 4-weeks increased to 48.5±4.01 in group-I and 45±4.29 in group-II (p-value=0.011).
CONCLUSION: McKenzie exercises are more significant and show more improvement in reduction of pain and associated symptoms of neck and increased movements quicker than isometric exercises.
Article Details
Work published in KMUJ is licensed under a
Creative Commons Attribution 4.0 License
Authors are permitted and encouraged to post their work online
(e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Bovim G, Schrader H, Sand T. Neck pain in general population. Spine 1994;19:1307-9. DOI: 10.1097/00007632-199406000-00001.
Chiu TTW, Leung ASL, Lam P. Neck pain in Hong Kong: a telephone survey on consequences and health service utilization. Spine 2010;35:E1088-95. DOI: 10.1097/BRS.0b013e3181e219fd.
Kilpikoski S. The McKenzie method in assessing, classifying and treating non-specific low back pain in adults with special reference to the centralization phenomenon. University of Jyväskylä; 2010.
May S, Donelson R. Evidence-informed management of chronic low back pain with the McKenzie method. Spine J 2008;8(1):134-41. DOI: 10.1016/j.spinee.2007.10.017.
Stanton TR, Fritz JM, Hancock MJ, Latimer J, Maher CG, Wand BM, Parent EC. Evaluation of a treatment-based classification algorithm for low back pain: a cross-sectional study. Phys Ther 2011 Apr 1;91(4):496-509. DOI: 10.2522/ptj.20100272.
Gupta S, Jaiswal P, Chhabra D. A comparative study between postisometric relaxation and isometric exercises in non-specific neck pain. J Exerc Sci Physiother 2008;4(2):88. DOI: 10.18376//2012/v8i2/67588.
Strimpakos N, Sakellari V, Gioftsos G, Oldham J. Intratester and intertester reliability of neck isometric dynamometry. Arch Phys Med Rehabil 2004 Aug 1;85(8):1309-16. DOI: 10.1016/j.apmr.2003.08.104.
Manca A, Dumville JC, Torgerson DJ, Klaber Moffett JA, Mooney MP, Jackson DA, Eaton S. Randomized trial of two physiotherapy interventions for primary care back and neck pain patients: cost effectiveness analysis. Rheumatology 2007;46:1495-501. DOI: 10.1093/rheumatology/kem183.
Rosner B. Fundamentals of Biostatistics. 4th ed. Duxbury Press; 1995. Page 221. Sample Size Calculation. 2018 [Cited on: June 18, 2018]; Available from URL: http://www.sample-size.net/sample-size-study-paired-t-test/.
Neeraj K, Shiv V. To Compare the Effect of Strengthening Neck Exercise and Mckenzie Neck Exercise In Neck Pain Subject. Med Health Res 2016;3(10):69-79.
Boonstra AM, Stewart RE, Köke AJ, Oosterwijk RF, Swaan JL, Schreurs KM, et al. Cut-off points for mild, moderate, and severe pain on the numeric rating scale for pain in patients with chronic musculoskeletal pain: variability and influence of sex and catastrophizing. Front Psychol 2016 Sep 30;7:1466. DOI: 10.3389/fpsyg.2016.01466.
Edmond SL, Cutrone G, Werneke M, Ward J, Grigsby D, Weinberg J, Oswald W, Oliver D, McGill T, Hart DL. Association between centralization and directional preference and functional and pain outcomes in patients with neck pain. J Orthopead Sport Phys Ther 2014 Feb;44(2):68-75. DOI: 10.2519/jospt.2014.4632.
Kjellman G, Oberg B. A randomized clinical trial comparing general exercise, McKenzie treatment and a control group in patients with neck pain. J Rehabil Med 2002 Jul 1;34(4):183-90. DOI: 10.1080/16501970213233.
Im B, Kim Y, Chung Y, Hwang S. Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture. Journal of physical therapy science. 2015;28(3):951-55. DOI: 10.1589/jpts.28.951.
Ylinen J, Takala EP, Nykänen M, Häkkinen A, Mälkiä E, Pohjolainen T, Karppi SL, Kautiainen H, Airaksinen O. Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. J Am Med Assoc (JAMA) 2003 May 21;289(19):2509-16. DOI: 10.1001/jama.289.19.2509.