Baumann Anthony N, Orellana Kevin, Landis Leah, Crawford Marc, Oleson Caleb J, Rogers Hudson, Curtis Deven P, Baldwin Keith D
Department of Rehabilitation Services, University Hospitals, Cleveland, USA.
Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, USA.
Cureus. 2023 May 19;15(5):e39218. doi: 10.7759/cureus.39218. eCollection 2023 May.
Neck pain is a common musculoskeletal condition frequently managed with numerous conservative interventions. The McKenzie method of mechanical diagnosis and therapy (MMDT) is a form of physical therapy evaluation and treatment that aims to improve pain and disability in patients with musculoskeletal pain, including neck pain. To date, no systematic review with meta-analysis has examined the use of the McKenzie MMDT for neck pain. This study aimed to examine the effectiveness of the McKenzie MMDT in adult patients with neck pain. A systematic review and meta-analysis were performed using PubMed, ScienceDirect, MEDLINE, CINAHL, Web of Science, and Google Scholar. Full search terms were "McKenzie method" OR "McKenzie approach" OR "McKenzie treatment" AND "neck pain." Inclusion criteria were the use of the McKenzie MMDT, level I randomized control trials (RCTs), adults, and outcomes of pain (0-10 scale) and disability (neck disability index). A total of 11 RCTs met the final selection criteria from 1,955 articles on initial search with 289 patients receiving the McKenzie MMDT out of 677 total patients. For meta-analysis, there was a clinically insignificant but statistically significant improvement in pain (1.14/10 points) in patients receiving the McKenzie MMDT versus control interventions (p<0.02). There was no significant improvement in the neck disability index score between the McKenzie MMDT versus control interventions (p=0.19). For severity of pain, there was a clinically and statistically significant improvement in moderate or severe pain (2.06/10 points; p<0.01), but not in mild-to-moderate pain (p=0.84) when comparing the McKenzie MMDT to control interventions. Overall, the McKenzie MMDT provides very small but statistically significant improvements in neck pain of all severity compared to control interventions. However, the McKenzie MMDT does provide clinically and statistically significant pain improvement in moderate-to-severe neck pain. Use of the McKenzie MMDT did not provide any significant improvement in disability compared to control interventions. This study is the first systematic review with meta-analysis on the effectiveness of the McKenzie MMDT for adult patients with neck pain.
颈部疼痛是一种常见的肌肉骨骼疾病，通常采用多种保守干预措施进行治疗。麦肯齐机械诊断与治疗方法（MMDT）是一种物理治疗评估和治疗形式，旨在改善包括颈部疼痛在内的肌肉骨骼疼痛患者的疼痛和功能障碍。迄今为止，尚无系统评价和荟萃分析研究麦肯齐MMDT在颈部疼痛治疗中的应用。本研究旨在探讨麦肯齐MMDT对成年颈部疼痛患者的有效性。使用PubMed、ScienceDirect、MEDLINE、CINAHL、Web of Science和谷歌学术进行了系统评价和荟萃分析。完整的检索词为“麦肯齐方法”或“麦肯齐途径”或“麦肯齐治疗”以及“颈部疼痛”。纳入标准为使用麦肯齐MMDT、I级随机对照试验（RCT）、成年人以及疼痛（0-10分制）和功能障碍（颈部功能障碍指数）的结果。在初步检索的1955篇文章中，共有11项RCT符合最终选择标准，677名患者中共有289名接受了麦肯齐MMDT治疗。在荟萃分析中，与对照干预相比，接受麦肯齐MMDT治疗的患者疼痛有临床意义不显著但统计学显著的改善（1.14/10分）（p<0.02）。麦肯齐MMDT与对照干预之间的颈部功能障碍指数评分无显著改善（p=0.19）。对于疼痛严重程度，与对照干预相比，中度或重度疼痛有临床和统计学显著改善（2.06/10分；p<0.01），但轻度至中度疼痛无显著改善（p=0.84）。总体而言，与对照干预相比，麦肯齐MMDT在所有严重程度的颈部疼痛方面提供了非常小但统计学显著的改善。然而，麦肯齐MMDT在中度至重度颈部疼痛方面确实提供了临床和统计学显著的疼痛改善。与对照干预相比，使用麦肯齐MMDT在功能障碍方面未提供任何显著改善。本研究是第一项关于麦肯齐MMDT对成年颈部疼痛患者有效性的系统评价和荟萃分析。
