Biomechanical Analysis of Mckenzie Method Therapy for Low Back Pain Patients
Abstract
Low Back Pain (LBP) is one of the most common musculoskeletal complaints and can interfere with daily activities. Various therapeutic methods have been developed to alleviate LBP symptoms, including the McKenzie Method and Core Stability Exercise. This study aims to analyze and compare the effectiveness of the McKenzie Method and Core Stability Exercise in reducing pain, improving range of motion (ROM), and decreasing disability levels in patients with LBP. This experimental study used a pretest-posttest control group design with a total sample of 33 patients diagnosed with non-specific LBP who met the inclusion criteria. The experimental group received McKenzie therapy, while the control group underwent Core Stability Exercise, each for 12 sessions (three times per week). Evaluations were conducted using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and lumbar ROM measurements (flexion, extension, right and left lateral flexion). The results showed that both therapy methods were effective in reducing pain and improving mobility. However, the McKenzie Method demonstrated significantly greater improvements, especially after 12 therapy sessions (ODI p=0.001; VAS movement p=0.000; ROM extension p=0.005). McKenzie therapy also showed significant improvements in right and left lateral flexion and other functional aspects such as personal care, sitting, standing, and social life (p<0.05). Conversely, although CSE produced faster results in the early phase, its long-term effectiveness was relatively lower than that of the McKenzie Method. Therefore, the McKenzie Method is more recommended as a therapeutic option for managing LBP due to its ability to provide more optimal long-term recovery.
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Chan, Y. H. (2003). Randomised controlled trials (RCTS) - Sample size: The magic number? Singapore Medical Journal, 44(4), 172–174.
Chen, J., Huang, Y., Yang, Y., Wang, Z., Zhao, D., Luo, M., & Pu, F. (2024). Vertebral bone quality score was associated with paraspinal muscles fat infiltration , but not modic classification in patients with chronic low back pain : a prospective cross-sectional study. 1–8.
Dahlan, M. S. (2010). Sample Size and Sampling Methods in Medical Research 3rd Edition (A. Suslia (ed.)). Salemba Medika.
Freitas, J. P., Corrêa, L. A., Bittencourt, J. V., Armstrong, K. M., Meziat-Filho, N., & Nogueira, L. A. C. (2024). One spinal manipulation session reduces local pain sensitivity but does not affect postural stability in individuals with chronic low back pain: a randomised, placebo-controlled trial. Chiropractic and Manual Therapies, 32(1), 1–12. https://doi.org/10.1186/s12998-024-00541-4
Iwata, S., Hashizume, H., Yoshimura, N., Oka, H., Iwahashi, H., Ishimoto, Y., Nagata, K., Teraguchi, M., Kagotani, R., Sasaki, T., Tanaka, S., Yoshida, M., & Yamada, H. (2024). Osteoporosis , spinal degenerative disorders , and their association with low back pain , activities of daily living , and physical performance in a general population. Scientific Reports, 1–10. https://doi.org/10.1038/s41598-024-64706-0
Lei, Y., Zhan, E., Chen, C., Hu, Y., Lv, Z., He, Q., Wang, X., Li, X., & Zhang, F. (2024). ALKBH5-mediated m6A demethylation of Runx2 mRNA promotes extracellular matrix degradation and intervertebral disc degeneration. Cell and Bioscience, 14(1), 1–19. https://doi.org/10.1186/s13578-024-01264-y
Mbada, C., Olanipekun, O. O., Ademoyegun, A., & Egwu, M. O. (2024). Effectiveness of telerehabilitation based mckenzie method versus manual therapy in low back pain management : a randomised controlled trial. Bulletin of Faculty of Physical Therapy. https://doi.org/10.1186/s43161-024-00218-2
Namnaqani, F. I., Mashabi, A. S., Yaseen, K. M., & Alshehri, M. A. (2019). The effectiveness of McKenzie method compared to manual therapy for treating chronic low back pain: A systematic review. Journal of Musculoskeletal Neuronal Interactions, 19(4), 492–499.
Pires, D., Duarte, S., Rodrigues, A. M., Caeiro, C., Canhão, H., Branco, J., Alves, J., Marques, M., Aguiar, P., Fernandes, R., Sousa, R. D., & Cruz, E. B. (2024). MyBack - effectiveness and implementation of a behavior change informed exercise programme to prevent low back pain recurrences: a hybrid effectiveness-implementation randomized controlled study protocol. BMC Musculoskeletal Disorders, 25(1), 1–12. https://doi.org/10.1186/s12891-024-07542-7
Putri, R., Sari, I. P., Delidios, & Ruswaldi. (2023). The Relationship Of Work Attitude And Duration Of Riding With Low Back Pain ( LBP ) In Online Ojek Motorcycle Drivers In Pekanbaru City. 1(3).
Rhon, D. I., Fritz, J. M., Greenlee, T. A., Dry, K. E., Mayhew, R. J., Laugesen, M. C., Dragusin, E., & Teyhen, D. S. (2024). Correction : move to health-a holistic approach to the management of chronic low back pain : an intervention and implementation protocol developed for a pragmatic clinical trial. 12967.
Takasaki, H. (2023). Predictors of 1-Year Perceived Recovery , Absenteeism , and Expenses Due to Low Back Pain in Workers Receiving Mechanical Diagnosis and Therapy : A Prospective Cohort Study. 1–11.
Khan, J., khan, P., Arshad, M. U., Javed, A., Zia, wajeeha, Iqbal, A., & Jamshaid, G. (2022). Comparative effects of Core Stability Exercises and Endurance Training in Patients with Mechanical Low Back Pain. Pakistan BioMedical Journal, 5(1), 332–336. https://doi.org/10.54393/PBMJ.V5I1.193
Lam, O. T., Strenger, D. M., Chan-Fee, M., Pham, P. T., Preuss, R. A., & Robbins, S. M. (2018). Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating Low Back Pain: Literature Review With Meta-analysis. The Journal of Orthopaedic and Sports Physical Therapy, 48(6), 476–490. https://doi.org/10.2519/JOSPT.2018.7562
Mann, S. J., Lam, J. C., & Singh, P. (2023, July). McKenzie Back Exercises. StatPearls; StatPearls Publishing.
Hlaing, S. S., Puntumetakul, R., Khine, E. E., & Boucaut, R. (2021). Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial. BMC Musculoskeletal Disorders, 22(1), 1–13. https://doi.org/10.1186/S12891-021-04858-6/TABLES/2
Louw, A., Farrell, K., Nielsen, A., O’Malley, M., Cox, T., & Puentedura, E. J. (2022). Virtual McKenzie extension exercises for low back and leg pain: a prospective pilot exploratory case series. The Journal of Manual & Manipulative Therapy, 31(1), 46. https://doi.org/10.1080/10669817.2022.2092822
Asmara, S., Marya, D., Putri, M., Kristiyanto, A., & Prasetya, H. (2021). Meta-Analysis the Effectiveness of McKenzie Exercise to Reduce Pain in Patients with Non-Specific Low Back Pain. Journal of Epidemiology and Public Health, 6(1), 33–41. https://doi.org/10.26911/JEPUBLICHEALTH.2021.06.01.06
Xu, S., Wang, R., Ma, S., & He, B. (2024). Interventional effect of core stability training on pain and muscle function of youth with chronic non-specific lower back pain: A randomized controlled trial. Heliyon, 10(12), e32818. https://doi.org/10.1016/J.HELIYON.2024.E32818
Narouei, S., Barati, A. hossein, Akuzawa, H., Talebian, S., Ghiasi, F., Akbari, A., & Alizadeh, M. hossein. (2020). Effects of core stabilization exercises on thickness and activity of trunk and hip muscles in subjects with nonspecific chronic low back pain. Journal of Bodywork and Movement Therapies, 24(4), 138–146. https://doi.org/10.1016/J.JBMT.2020.06.026
Frank, C., Kobesova, A., Kolar, P., & Permanente, K. (2013). Dynamic Neuromuscular Stabilization and Sports Rehabilitation. International Journal of Sports Physical Therapy, 8(1), 62.
Albert, H. B., Hauge, E., & Manniche, C. (2012). Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions? European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 21(4), 630–636. https://doi.org/10.1007/S00586-011-2018-9
Rahmadi, R., Pradita, A., Endaryanto, A. H., & Fau, Y. D. (2024). Efektifitas Core Stability Terhadap Fleksibilitas Otot Lumbal Pada Kasus Low Back Pain Di Klinik Pupuk Kujang Cikampek. Jurnal Kesehatan Panrita Husada, 9(1).
Naveen, G., Ashraf, Y., Mahesh, R., Ramamoorthy, V., Rai, B. K. D., Indhu, R., & Anusuya, D. (2024). Effectiveness of Movement Control Exercise and Core Stability Exercise on Reducing Pain, Improving Range of Motion and Functional Activities in Patients with Mechanical Low Back Pain. International Journal of Health Sciences and Research (Www.Ijhsr.Org), 14(7), 409. https://doi.org/10.52403/ijhsr.20240753
Kumbea, N. P., Sumampouw, O. J., & Asrifuddin, A. (2021). Complaint of Low Back Pain in Fishermen. Indonesian Journal of Public Health and Community Medicine, 2(1), 021–026. https://doi.org/10.35801/IJPHCM.2.1.2021.33580
Heuch, I., Heuch, I., Hagen, K., & Zwart, J. A. (2024). Overweight and obesity as risk factors for chronic low back pain: a new follow-up in the HUNT Study. BMC Public Health, 24(1), 2618. https://doi.org/10.1186/S12889-024-20011-Z/TABLES/6
Russeng, S. S., Saleh, L. M., Wahyulianti, W. N., & Palutturi, S. (2021). The Effect of Age and Workload on Work Posture toward Musculoskeletal Disorders Complain on Loading and Unloading Workers. Open Access Macedonian Journal of Medical Sciences, 9(E), 1115–1121. https://doi.org/10.3889/OAMJMS.2021.7277
Frizziero, A., Pellizzon, G., Vittadini, F., Bigliardi, D., & Costantino, C. (2021). Efficacy of Core Stability in Non-Specific Chronic Low Back Pain. Journal of Functional Morphology and Kinesiology 2021, Vol. 6, Page 37, 6(2), 37. https://doi.org/10.3390/JFMK6020037
Gill, G., Jagga, V., & Pal, S. (2024). Efficacy and Effectiveness of McKenzie Exercises in Chronic Low Back Pain Management: A Comprehensive Review. International Journal of Health Sciences and Research, 14(9), 212–220. https://doi.org/10.52403/IJHSR.20240927
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Copyright (c) 2025 Afif Nashrullah, Iqbal Basri, Sitti Rafiah, Reza Kurniawan Arta, Nirwana Fitriani Walenna, Rustam HN

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