Effectiveness of Back School Versus McKenzie Exercises in Patients With Chronic Nonspecific Low Back Pain: A Randomized Controlled Trial.

Back School and McKenzie methods are widely accepted active treatment approaches that include both exercises and information for patients with chronic nonspecific low back pain.  This study, including 148 patients with chronic nonspecific low back pain, compared the efficacy of Back School and McKenzie methods in patients with chronic nonspecific low back pain.  The 4-week treatment program (one session/week) was based on the Back School (delivered to the group) or McKenzie (delivered individually) principles. The participants also were instructed to perform a daily set of home exercises.  Clinical outcomes were assessed at follow-up appointments at 1, 3, and 6 months after randomisation  Primary outcome measures were pain intensity (measured by the 0-10 pain numerical rating scale) and disability (measured by the 24-item Roland-Morris Disability Questionnaire) 1 month after randomisation  Secondary outcome measures were pain intensity and disability at 3 and 6 months after randomisation  quality of life (measured by the World Health Organization Quality of Life-BREF instrument) at 1, 3, and 6 months after randomisation, and trunk flexion range of motion measured by an inclinometer at 1 month after randomization. The participants allocated to the McKenzie group had greater improvements in disability at 1 month but not for pain. No between-group differences were observed for all secondary outcome measures.

The study found that the McKenzie method (a more resource-intensive intervention) was slightly more effective than the Back School method for disability, but not for pain severity immediately following treatment in participants with chronic low back pain.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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