Szulc Paweł, Wendt Michał, Waszak Małgorzata, Tomczak Maciej, Cieślik Krystyna, Trzaska Tadeusz
Department of Functional Anatomy, University School of Physical Education, Poznań, Poland.
Department of Sports Medicine and Traumatology, University School of Physical Education, Poznań, Poland.
Med Sci Monit. 2015 Sep 29;21:2918-32. doi: 10.12659/MSM.894261.
The high incidence and inconsistencies in diagnostic and therapeutic process of low back pain (LBP) stimulate the continuing search for more efficient treatment modalities. Integration of the information obtained with various therapeutic methods and a holistic approach to the patient seem to be associated with positive outcomes. The aim of this study was to analyze the efficacy of combined treatment with McKenzie method and Muscle Energy Technique (MET), and to compare it with the outcomes of treatment with McKenzie method or standard physiotherapy in specific chronic lumbar pain.
The study included 60 men and women with LBP (mean age 44 years). The patients were randomly assigned to 1 of 3 therapeutic groups, which were further treated with: 1) McKenzie method and MET, 2) McKenzie method alone, or 3) standard physiotherapy for 10 days. The extent of spinal movements (electrogoniometry), level of experienced pain (Visual Analogue Scale and Revised Oswestry Pain Questionnaire), and structure of the spinal discs (MRI) were examined prior to the intervention, immediately thereafter, and 3 months after the intervention.
McKenzie method enriched with MET had the best therapeutic outcomes. The mobility of cervical, thoracic, and lumbar spine normalized at levels corresponding to 87.1%, 66.7%, and 95% of respective average normative values. Implementation of McKenzie method, both alone and combined with MET, was associated with a significant decrease in Oswestry Disability Index, significant alleviation of pain (VAS), and significantly reduced size of spinal disc herniation.
The combined method can be effectively used in the treatment of chronic LBP.
下腰痛（LBP）诊断和治疗过程中的高发病率及不一致性促使人们不断寻求更有效的治疗方式。整合通过各种治疗方法获得的信息并对患者采取整体治疗方法似乎与积极的治疗效果相关。本研究的目的是分析麦肯齐方法与肌肉能量技术（MET）联合治疗的疗效，并将其与麦肯齐方法或标准物理治疗在特定慢性腰痛治疗中的效果进行比较。
该研究纳入了60名患有LBP的男性和女性（平均年龄44岁）。患者被随机分配到3个治疗组中的1组，随后分别接受以下治疗：1）麦肯齐方法和MET，2）单独的麦肯齐方法，或3）标准物理治疗，为期10天。在干预前、干预后立即以及干预后3个月，对脊柱活动范围（电子测角法）、疼痛程度（视觉模拟量表和修订的奥斯威斯利疼痛问卷）以及椎间盘结构（MRI）进行检查。
采用MET强化的麦肯齐方法具有最佳治疗效果。颈椎、胸椎和腰椎的活动度恢复正常，分别达到各自平均标准值的87.1%、66.7%和95%。单独使用麦肯齐方法以及将其与MET联合使用，均与奥斯威斯利功能障碍指数显著降低、疼痛（VAS）显著减轻以及椎间盘突出大小显著减小相关。
联合方法可有效用于慢性LBP的治疗。
