Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: ‘McKenzie’ vs brief physiotherapy pain management

Moffett, Jennifer A. Klaber and Jackson, David A. and Gardiner, E.D. and Torgerson, David J. and Coulton, Simon and Eaton, S. (2006) Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: ‘McKenzie’ vs brief physiotherapy pain management. Rheumotology, 45 (12). pp. 1514-1521. ISSN 1462-0324. (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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Objectives. Interventions that take psychosocial factors into account are recommended for patients with persistent back or neck pain. We compared the effectiveness of a brief physiotherapy pain management approach using cognitive–behavioural principles (Solution-Finding Approach—SFA) with a commonly used method of physical therapy (McKenzie Approach—McK). Methods. Eligible patients referred by GPs to physiotherapy departments with neck or back pain lasting at least 2 weeks were randomized to McK (n= 161) or to SFA (n= 154). They were further randomized to receive an educational booklet or not. The primary outcome was the Tampa Scale of Kinesiophobia (TSK) (Activity-Avoidance scale used as a proxy for coping) at 6 weeks, and 6 and 12 months. Results. Of 649 patients assessed for eligibility, 315 were recruited (219 with back pain, 96 with neck pain). There were no statistically significant differences in outcomes between the groups, except that at any time point SFA patients supported by a booklet reported less reliance on health professionals (Multidimensional Health Locus of Control Powerful Others Scale), while at 6 months McK patients showed slightly more improvement on activity-avoidance (TSK). At 6 weeks, patient satisfaction was greater for McK (median 90% compared with 70% for SFA). Both interventions resulted in modest but clinically important improvements over time on the Roland Disability Questionnaire Scores and Northwick Park Neck Pain Scores. Conclusions. The McK approach resulted in higher patient satisfaction overall but the SFA could be more cost-effective, as fewer (three vs four) sessions were needed.

Item Type: Article
Uncontrolled keywords: Physical therapy, Neck pain, Back pain, Randomized trial, Primary care
Subjects: R Medicine > R Medicine (General)
R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 22 Jun 2011 10:48
Last Modified: 15 May 2014 11:55
Resource URI: https://kar.kent.ac.uk/id/eprint/27955 (The current URI for this page, for reference purposes)
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