Clinicians
The McKenzie Method® of Mechanical Diagnosis and Therapy®
McKenzie method is recommended as a classification based treatment system and some of the relevant evidence presented.
McKenzie exercises are recommended with good-quality patient-oriented evidence.
This clinical practice guideline developed by a panel of international experts made recommendations on the management of knee OA in regards to strengthening exercises. MDT was 'strongly recommended' as an intervention for this population.
View article sourceThis guideline for diagnosis and treatment of low back pain found insufficient evidence that a self-directed McKenzie program for acute low back pain results in different outcomes than usual care. It found poor quality evidence that MDT is an option for the treatment of chronic low back pain, but insufficient evidence that MDT results in different outcomes in chronic low back pain when compared to dynamic strengthening or back school.
View article sourceThis wide ranging review and guideline includes a summary of the McKenzie approach, both as a treatment and as a diagnostic method. They concluded there was limited evidence to support its use as a treatment for both acute and chronic back pain, and moderate evidence indicating its value as a diagnostic tool and prognostic indicator.
Clinical guidelines that address numerous aspects of back pain, such as classification, red flags, risk factors, outcome measures, physical examination tests, screening tools, and interventions. Amongst other recommendation it was recommended that clinicians should use specific repeated movements to promote centralization in patients with acute low back pain; with recommendation based on strong evidence.
This treatment guideline recommends an early mechanical evaluation using repeated movements to check for directional preference and centralisation and states that these are indicators of improved outcomes. It also states that 'specific' exercises, like directional preference exercises, appear helpful in the treatment of low back pain
View article sourceThis paper summarises the Danish national clinical guidelines for recent onset neck pain and radiculopathy. Evidence in general was weak and many recommendations were based on consensus. Directional preference exercises were considered as one of the options for exercises for neck pain with 'low confidence in the effect size'. For cervical radiculopathy it was stated that "It is good clinical practice to consider treatment with directional exercise in patients with recent onset cervical radiculopathy in addition to other treatment".
View article sourceThese guidelines have been developed using a structured and rigorous methodology. For sub-acute and chronic back pain they recommend that there is good evidence to include certain specific exercises, including the McKenzie method.
Development of a clinical management model for back pain patients from previously published guidelines and systematic reviews. McKenzie approach was listed as a recommended therapeutic intervention for acute and for chronic back pain with poor scientific evidence; and for sub-acute back pain with moderate scientific evidence.
View article sourceMcKenzie recommended for sub-acute back pain with moderate scientific evidence, and for chronic back pain with weak scientific evidence.
These Danish guidelines were based on systematic reviews and meta-analyses and offered grades of recommendations on interventions. Directional Preference exercises were given a weak/conditional recommendation.
View article sourceMcKenzie recommended for acute and chronic back pain. Guidelines noted the reliability of assessment with trained therapists; the value of sub-grouping using centralisation; and the ability of McKenzie method to improve pain and disability in the short-term. This was supported by best levels of evidence: systematic reviews and RCTs.