McKenzie method

The McKenzie method (also MDT) is a comprehensive method of care primarily used in physical therapy. New Zealand physical therapist Robin McKenzie, OBE (1931–2013) developed the method in the late 1950s. In 1981 he launched the concept which he called Mechanical Diagnosis and Therapy (MDT) – a system encompassing assessment (evaluation), diagnosis and treatment for the spine and extremities. MDT categorises patients' complaints not on an anatomical basis, but subgroups them by the clinical presentation of patients. Research has found that the McKenzie method has, at most, limited benefit for helping alleviate acute back pain. It is of no benefit for chronic back pain. According to a meta-analysis of clinical trials in 2006, treatment using the McKenzie method is somewhat effective for acute low back pain, but the evidence suggests that it is not effective for chronic low-back pain. A 2012 systematic review agreed with this, finding that centralisation occurred more frequently in acute patients (74%) compared to subacute (50%) and chronic (40%). Also, centralisation was found to be more common in younger patients. Cervical centralisation was observed in only 37% of patients. A 2006 systematic review into the clinical evidence of the McKenzie method's ability to treat spinal pain concluded that the McKenzie method decreased short-term (<3 months) to a higher degree than other standard treatments including: 'nonsteroidal anti-inflammatory drugs, educational booklet, back massage with back care advice, strength training with therapist supervision, and spinal mobilization'. At the intermediate term follow-up there was no statistical differences among therapies. A report published in 2008 noted only marginal benefits over an assessment and advice-only group at the short-term follow up mark, 6 month, and 1 year. A 2010 study concluded that the McKenzie method 'does not produce appreciable additional short-term improvements in pain, disability, function or global perceived effect'. A 2006 systematic review of the literature assessed whether or not the McKenzie method treated Lower back pain more effectively than passive therapy, advice to stay active, flexion exercises, and others. The assessment concluded that there were no clinically significant benefits compared with the passive therapy and advice to stay active in those with acute lower back pain