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

J. Klaber Moffett; D. A. Jackson; E. D. Gardiner; D. J. Torgerson; S. Coulton; S. Eaton; M. P. Mooney; C. Pickering; A. J. Green; L. G. Walker; S. May; S. Young

doi:10.1093/rheumatology/ke1339

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

J. Klaber Moffett, D. A. Jackson, E. D. Gardiner, D. J. Torgerson, S. Coulton, S. Eaton, M. P. Mooney, C. Pickering, A. J. Green, L. G. Walker, S. May, S. Young

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English
Pages (from-to)	1514-1521
Number of pages	8
Journal	Rheumatology
Volume	45
Issue number	12
DOIs	https://doi.org/10.1093/rheumatology/ke1339
Publication status	Published - Dec 2006

Keywords

physical therapy
neck pain
back pain
randomized trial
primary care
PHYSICAL-THERAPY
RISK-FACTORS
DISABILITY
PROGRAM
DEPRESSION
EXERCISE
SCALE

Access to Document

10.1093/rheumatology/ke1339

http://dx.doi.org/10.1093/rheumatology/kel339

Cite this

Klaber Moffett, J., Jackson, D. A., Gardiner, E. D., Torgerson, D. J., Coulton, S., Eaton, S., Mooney, M. P., Pickering, C., Green, A. J., Walker, L. G., May, S., & Young, S. (2006). Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: 'McKenzie' vs brief physiotherapy pain management. Rheumatology, 45(12), 1514-1521. https://doi.org/10.1093/rheumatology/ke1339

@article{cc4fb8c9182c48a1887bb2ae4df607c5,

title = "Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: 'McKenzie' vs brief physiotherapy pain management",

abstract = "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.",

keywords = "physical therapy, neck pain, back pain, randomized trial, primary care, PHYSICAL-THERAPY, RISK-FACTORS, DISABILITY, PROGRAM, DEPRESSION, EXERCISE, SCALE",

author = "{Klaber Moffett}, J. and Jackson, {D. A.} and Gardiner, {E. D.} and Torgerson, {D. J.} and S. Coulton and S. Eaton and Mooney, {M. P.} and C. Pickering and Green, {A. J.} and Walker, {L. G.} and S. May and S. Young",

year = "2006",

month = dec,

doi = "10.1093/rheumatology/ke1339",

language = "English",

volume = "45",

pages = "1514--1521",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

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}

Klaber Moffett, J, Jackson, DA, Gardiner, ED, Torgerson, DJ, Coulton, S, Eaton, S, Mooney, MP, Pickering, C, Green, AJ, Walker, LG, May, S & Young, S 2006, 'Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: 'McKenzie' vs brief physiotherapy pain management', Rheumatology, vol. 45, no. 12, pp. 1514-1521. https://doi.org/10.1093/rheumatology/ke1339

TY - JOUR

T1 - Randomized trial of two physiotherapy interventions for primary care neck and back pain patients: 'McKenzie' vs brief physiotherapy pain management

AU - Klaber Moffett, J.

AU - Jackson, D. A.

AU - Gardiner, E. D.

AU - Torgerson, D. J.

AU - Coulton, S.

AU - Eaton, S.

AU - Mooney, M. P.

AU - Pickering, C.

AU - Green, A. J.

AU - Walker, L. G.

AU - May, S.

AU - Young, S.

PY - 2006/12

Y1 - 2006/12

N2 - 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.

AB - 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.

KW - physical therapy

KW - neck pain

KW - back pain

KW - randomized trial

KW - primary care

KW - PHYSICAL-THERAPY

KW - RISK-FACTORS

KW - DISABILITY

KW - PROGRAM

KW - DEPRESSION

KW - EXERCISE

KW - SCALE

U2 - 10.1093/rheumatology/ke1339

DO - 10.1093/rheumatology/ke1339

M3 - Article

VL - 45

SP - 1514

EP - 1521

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 12

ER -