McKenzie Method in Physiotherapy (Diagnosis and Mechanical Therapy): Application of Logical Clinical Reasoning and Systematic Review

Abstract

INTRODUCTION: The McKenzie method used in spinal disorders is based on the possibility of reduction or abolition of pain from the use of movements, with a preference for targeting, re-education and self-correction of postural patterns, mobilizations and joint manipulations, with adjustments of furniture when necessary. OBJECTIVE: To present the general grounds of the method, as well as results of randomized clinical trials published in the last decade. METHODS: Study of the application of logical clinical reasoning based on a systematic review of the literature. RESULTS: Initial assessment is required to analyze pain characteristics and to classify patients as having: Postural Syndrome, Dysfunction Syndrome or Disruption Syndrome. By identifying movement that minimizes pain, it is selected to begin treatment. Two sets of 10 - 15 repetitions are indicated, sustained for 1 - 2 seconds, with the patient always trying to reach the maximum range of motion. Despite the primary choice for a particular movement, as the patient evolves, all movements should be added to the treatment in order to provide greater tissue elasticity. To complement, the method proposes mobilizations and joint manipulations. CONCLUSION: It should be emphasized that this is another strategy that can be used, but not the "gold standard" of treatment for lumbar dysfunctions. Significant evidence indicates that, alone or in association with other techniques, the McKenzie method has positive effects in the treatment of low back pain.