McKenzie concept

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Robin Anthony McKenzie

The McKenzie concept (also MDT = mechanical diagnosis and therapy ) is a method of physiotherapy . The New Zealand physiotherapist Robin McKenzie (born 1931, died May 13, 2013) developed it. In 1981 he published his concept, which he himself called Mechanical Diagnosis and Therapy (MDT) and which is now standardized in 36 countries.

McKenzie's core statement is: "Anatomical diagnoses" are seldom possible in the spine and joints and are not very helpful for treatment. It is more efficient to classify complaints according to which therapy helps the person affected. MDT according to McKenzie primarily uses the patients' own exercises and reduces manual techniques to a minimum. Only when the intensity of the exercise program adapted to the particular symptoms is insufficient does the McKenzie therapist help with certain movements to intensify the exercise effect. McKenzie believes that self-treatment can reduce neck and back pain in the long term. To do this, he demands therapeutic autonomy and personal responsibility.

A diagnostically relevant phenomenon in this context is the pain centralization that occurs in the course of treatment. The pain withdraws from the extremities in sections and continuously and can become significantly stronger near the spine . If this phenomenon occurs, it is considered to be prognostically favorable and pointing the way for further therapy . The McKenzie investigation has been rated as reliable in studies. Studies estimate them to be as efficient as other popular methods. Recent research suggests that MDT treatment is more effective than chiropractic treatment in certain subsets of back patients. The McKenzie method is used worldwide, for example, for deep back pain, neck pain and joint complaints.

literature

  • MJ Kolber, WJ Hanney: The dynamic disc model: a systematic review of the literature . In: Phys Ther Rev , 2009, 14, pp. 181-295.
  • W Dankaerts, P O'Sullivan, A Burnett, L Straker, P Davey, R Gupta: Discriminating health controls and two clinical subgroups of non-specific chronic low back pain patients using trunk muscle activation and lumbosacral kinematics of postures and movements . In: Spine , 2009, 34, pp. 1610-1618.
  • MJ Hancock, CG Maher, J Latimer, MF Spindler, JH McAuley, M Laslett, N Bogduk: Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain . In: Eur Spine J , 2007, 16, pp. 1539-1550.
  • MW Werneke, DL. Hart: Categorizing patients with occupational low back pain by use of the Quebec Task Force Classification system versus pain pattern classification procedures: discriminant and predictive validity . In: Phys Ther , 2004 Mar, 84 (3), pp. 243-254.
  • S Young, C Aprill, M Laslett: Correlation of clinical examination characteristics with three sources of chronic low back pain . In: Spine , 2003, 3, pp. 460-465.

Web links

Individual evidence

  1. ^ RA McKenzie, Stephen May: The Cervical and Thoracic Spine, Mechanical diagnosis & therapy. In: Spinal Publications New Zealand , 2006
  2. ^ RA McKenzie, Stephen May: The lumbar spine. Mechanical diagnosis & therapy. In: Spinal Publications New Zealand , 2003
  3. ↑ J. Saner-Bissig: McKenzie - Mechanical diagnosis and therapy . 1st edition. Thieme, Stuttgart 2007, ISBN 978-3-13-143991-8 , thieme.de
  4. ↑ BE Udermann, KF Spratt, RG Donelson, J Mayer, JE Graves, J Tillotson: Can a patient educational book change behavior and reduce pain in chronic back pain patients? In: Spine J , 4, pp. 425-435, 2004 doi : 10.1016 / j.spinee.2004.01.016
  5. ^ S May, R Donelson: Evidence-informed management of chronic low back pain with the McKenzie method. In: The Spine Journal , 2008, 8, pp. 134-141
  6. ^ S May, E Gardiner, S Young, J Klaber-Moffett: Predictor variables for a positive long-term functional outcome in patients with acute and chronic neck and back pain treated with a McKenzie approach: a secondary analysis . In: J Manual Manip Ther , 16, 2008, pp. 155-160
  7. ^ MW Werneke, DL Hart, SZ George, PW Stratford, JW Matheson, A Reyes: Clinical outcomes for patients classified by fear-avoidance beliefs and centralization phenomenon . In: Arch Phys Med Rehab , 90, 2009, pp. 768-777, PMID 19406296
  8. ^ MW Werneke et al .: Centralization: Prevalence and Effect on Treatment Outcomes Using a Standardized Operational Definition and Measurement Method. In: JOSPT , 38, 3, 2008, pp. 116–125, jospt.org ( memento of the original from April 28, 2009 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.jospt.org
  9. ↑ M Laslett, B Oberg, CN Aprill, B McDonald: Centralization as a predictor of provocation discography results in chronic low back pain, and the influence of disability and distress on diagnostic power . In: Spine J , 5, 2005, pp. 370-380, doi : 10.1016 / j.spinee.2004.11.007
  10. ^ A. Aina, S. May: The centralization phenomenon of spinal symptoms - a systematic review. In: Manual Therapy , 2004, pp. 134-143
  11. ^ L Skytte, S May, P Petersen: Centralization: Its prognostic value in patients with referred symptoms and sciatica . In: Spine , 30, 2005, pp. E293-E299, journals.lww.com
  12. ↑ SZ George, JE Bialosky, DA Donald: The centralization phenomenon and fear-avoidance beliefs as prognostic factors for acute low back pain: a preliminary investigation Involving patients classified for specific exercise . In: J Orthop Sports Phys Ther , 35, 2005, pp. 580-588
  13. ^ M Werneke, DL. Hart: Centralization phenomenon as a prognostic factor for chronic low back pain and disability . In: Spine , 2001 Apr 1, 26 (7), pp. 758-765
  14. ↑ a b S May, J Ross: The McKenzie Classification System in the Extremities: A Reliability Study Using McKenzie Assessment Forms and Experiences Clinicians. In: Journal of Manipulative and Physiological Therapeutics , Vol. 32, 7, 2009, PMID 19748407
  15. ↑ HA Clare, R Adams, CG Maher: Reliability of McKenzie classification of patients with cervical and lumbar pain In: Journal of Manipulative and Physiological Therapeutics , 2005 Feb, 28 (2), pp. 122-127
  16. ^ HA Clare, R Adams, CG Maher: Reliability of the McKenzie spinal pain classification using patient assessment forms . In: Physiotherapy , 90, 2004, pp. 114-119, physiotherapyjournal.com
  17. ^ HA Clare, R Adams, CG Maher: Reliability of detection of lumbar lateral shift . In: Journal of Manipulative and Physiological Therapeutics , 2003 Oct, 26 (8), pp. 476-480, jmptonline.org
  18. ↑ S Kilpikoski, O Airaksinen, M Kankaanpaa, P Leminen, T Videman, M. Alen: interexaminer reliability of low back pain assessment using the McKenzie method . In: Spine , 2002 Apr 15, 27 (8), pp. E207-214
  19. Jump up ↑ AG Chorti, AG Chortis, N Strimpakos, CJ McCarthy, SE Lamb: The prognostic value of symptom responses in the conservative management of spinal pain. A systematic review. In: Spine , 2009, 34, pp. 2686-2699
  20. ↑ H Razmjou, JF Kramer, R Yamada: interrater reliability of the McKenzie evaluation in assesing patients with mechanical low-back pain . In: J Orthop Sports Phys Ther , 2000 Jul, 30 (7), pp. 368–383, jospt.org  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.@1@ 2Template: Dead Link / www.jospt.org  
  21. ↑ a b A Long, R Donelson, T. Fung: Does it matter which exercise? A randomized control trial of exercise for low back pain. In: Spine , 2004, 29, pp. 2593-2602, journals.lww.com
  22. ↑ Luciana AC Machado, Chris G Maher, Rob D Herbert, Helen Clare, James H McAuley: The effectiveness of the McKenzie method in addition to first-line care for acute low back pain: a randomized controlled trial . In: BMC Medicine , 2010, 8, p. 10, doi: 10.1186 / 1741-7015-8-10 , biomedcentral.com
  23. ↑ Audrey Long et al .: Specific Directional Exercises for Patients with Low Back Pain: A Case Series . In: Physiotherapy Canada , 2008, Volume 60, Number 4, metapress.com  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice.@1@ 2Template: Dead Link / utpjournals.metapress.com  
  24. ↑ R Schenk, Jozefczyk, A Head: A randomized trial comparing interventions in patients with lumbar posterior derangement . In: J Man & Manip Ther , 2003 11, pp. 95-102
  25. ↑ LAC Machado, MvS de Souza, PH Ferreira, ML Ferreira: The McKenzie Method for low back pain. A systematic review of the literature with a meta-analysis approach . In: Spine , 2006, 31, pp. E254-E262
  26. ^ HA Clare, R Adams, CG Maher: A systematic review of efficacy of McKenzie therapy for spinal pain . In: Aust J Physiother , 2004, 50 (4), pp. 209-216
  27. ^ T Petersen, P Kryger, C Ekdahl, S Olsen, S. Jacobsen: The effect of McKenzie therapy as compared with that of intensive strengthening training for the treatment of patients with subacute or chronic low back pain: A randomized controlled trial . In: Spine , 2002 Aug 15, 27 (16), pp. 1702-1709 journals.lww.com
  28. ^ T Petersen, K Larsen, J Nordsteen, S Olsen, G Fournier, S. Jacobsen: The McKenzie Method Compared With Manipulation When Used Adjunctive to Information and Advice in Low Back Pain Patients Presenting With Centralization or Peripheralization: A Randomized Controlled Trial . In: Spine , 2011, 36, pp. 1999-2010, journals.lww.com
  29. ↑ MM Spoto, J Collins: Physiotherapy diagnosis in clinical practice: a survey of orthopedic certified specialists . In: Physio Res Int , 2008, 13, pp. 31-41, PMID 18189334 .
  30. ^ SJ Horton, A Franz: Mechanical Diagnosis and Therapy approach to assessment and treatment of derangement of the sacro-iliac joint . In: Manual Therapy , 2007 12, pp. 126-132
  31. ^ ER Miller, RJ Schenk, JL Karnes, JG Rousselle: A comparison of the McKenzie approach to a specific spine stabilization program for chronic low back pain . In: J Man & Manip Ther , 2005, 13, pp. 103-112
  32. ↑ European Guidelines for the Management of Acute Nonspecific Low Back Pain in Primary Care. COST B13 Working Group on Guidelines for the Management of Acute Low Back Pain in Primary Care, 2005, p. 22, backpaineurope.org ( Memento des original from 22. November 2009 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 271 kB) @1@ 2Template: Webachiv / IABot / www.backpaineurope.org
  33. ^ RJ Schrupp: Honoring Our “Giants” . In: Advance for Physical Therapy & Rehab Medicine , 2004, Vol. 15, Issue 14, p. 61
  34. ^ R Schenk et al .: Inclusion of Mechanical Diagnosis and Therapy (MDT) in the Management of Cervical Radiculopathy: A Case Report. In: The Journal of Manual & Manipulative Therapy , 2008, Vol. 16 No. 1, pp. E2-E8
  35. ^ RA McKenzie, S May: The Human Extremities. Mechanical diagnosis & therapy. In: Spinal Publications New Zealand , 2000
  36. ^ S Kaneko, H Takasaki, S May: Application of mechanical diagnosis and therapy to a patient diagnosed with de Quervain's disease: a case study . In: Journal of Hand Therapy , 2009, 22, pp. 278-284 jhandtherapy.org
  37. ↑ A Aina, S. May: A shoulder derangement . In: Manual Therapy , Volume 10, Issue 2, pp. 159-163