McKenzie Method in Combination with (as a part of) the Classic Physiotherapy in the Treatment of Patients with Chronic Pain in the Cervical Region of the Spine
Authors:
M. Hagovská 1; P. Takáč 1,2; J. Petrovičová 2
Authors‘ workplace:
Klinika fyziatrie, balneológie a liečebnej rehabilitácie LF UPJŠ, Košice
1; Ústav lekárskej informatiky, UPJŠ, Lekárska fakulta, Košice
2
Published in:
Rehabil. fyz. Lék., 20, 2013, No. 2, pp. 81-89.
Category:
Original Papers
Overview
The objective of the work:
The comparison of the effect of special rehabilitation the McKenzie method and classic physiotherapy in patients with chronic pain in cervical spine region, based on muscle tone reduction (m. trapezius) evaluated by means of the surface EMG, decline of disability.
In the group of patients treated by McKenzie method the monitoring of the association of the centralization phenomenon with m. trapezius tone values was conducted.
Patient sample:
Our patient research sample consisted of 55 patients who were divided into two groups by a stratified selection. The group A was treated by McKenzie method (n=30). The group B was treated by classical physiotherapy (n=25). The control group C consisted of healthy individuals (n=24) without any therapeutic intervention.
Methods used:
For the measurement of disability we used Neck disability index /NDI/. For the measurement of muscle tone we used the surface EMG, applying two-channel EMG apparatus- Biofeedback 2000 x-pert. The muscle tone values were measured in μV, on loaded, during performing repetition elevation of shoulder blade. Assessment of centralization phenomenon was used.
Results:
Before treatment In overall score evaluation in both groups A, B there were no significant differences recorded. The m. trapezius muscle tone values in healthy individuals C, were significantly lower (p<0.05), in comparison with groups A, B. In the A group the centralization phenomenon was recorded after one week in 60 %, after one month in 100 % patiens. One month after the treatment in both groups A, B a significant decline of disability occurred (p<0.05). There was no significant decrease of m. trapezius tone. Three months after the treatment further disability decline was recorded in groups A, B. In the assessment of m. trapezius muscle tone in μV in both groups occurred (p<0.05). At the same time the measured muscle tone values in μV were comparable with values in healthy individuals without pain.
Conclusion:
In the presented study we report how we managed to significantly reduce the of disability one month and three month after the treatment in groups A,B( p< 0.05) and also to significantly reduce m. trapezius tone reduction under loading three months after the treatment in both groups A, B (p< 0.05). The association between the centralization phenomenon and m. trapezius tone decrease was not proven.
Keywords:
surface EMG, cervicobrachial syndrome, McKenzie method
Sources
1. AINA, A., MAY, S., CLARE, H.: The centralization phenomenon of spinal symptom – a systematicrewiew. Manual Therapy, 9, 2004, s. 134-143.
2. AL-OBAIDI, S. M., NOWALL, A. A., NAKHI, H. B., AL-MANDEEL, M.: Evaluation of the McKenzie intervention for chronic low back pain by using selected physical and bio-behavioral outcome measures. Phys. Med. Rehab., 3, 2011, s. 637-646.
3. ALBERT. H. B., HAUGE, E., MANNICHE, C.: Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions? Eur Spine J. DOI 10:1007/s00586-011-2018-9, 2012.
4. ABDULWAHAB, S., SABBAHANI, M.: Neck retractions, cervical root decompression, and radicular pain. In: J. Ortop. Sports Phys. Ther, [online], roč. 30, 2000, č. 4, s. 4-12.
5. CLARE, H. A., ADAMS, R., MAHER,C. G.: Construct validity of lumbar extension measures in McKenzie’s derangement syndrome. Manual Therapy, 12, 2007, s. 328-334.
6. De MEY, K., CAGNIE, B., VAN DER VELDE, A., DANNEELS L.A., COOLS A.: Trapezius muscle timing during selected shoulder rehabilitation exercises. J. Orthop. Sports Phys.Ther., 39, 2009, 10,s. 743-752.
7. DYLEVSKÝ, I.: Funkční anatomie. Grada, 2009, 544 s., ISBN 978-80-247-3240-4.
8. HAGOVSKÁ, M., TAKÁČ, P.: Návrh hodnotenia sily svalov panvového dna u pacientok inkontinentných aj bez inkontinencie. In: Rehabilitace a fyzikální lékařství, roč. 17, 2010, č. 3, s. 87-94, ISSN 1211-2658.
9. HUPKA, J.: Fyzikálna terapia. Osveta, 1993, s. 10, ISBN 80-217 – 0568-X.
10. HOLLANDEROVÁ, D., PAVLŮ, D., PÁNEK, D.: Hodnocení EMG aktivity horní části m. trapezius při cviku proti pružnému odporu ve vodním prostředí a na suchu. Rehabilitace a fyzikální lékařství, roč. 19, 2012, č. 1, s. 35, ISSN 1211 – 2658.
11. JANDA, V. a kol.: Svalové funkční testy. Grada, 2004, s. 34, 41, 76-83, ISBN 80-247-0722 – 5.
12. McKENZIE, R.: Léčime si bolesti krční páteře sami. 1. vydání, 2005, 55 s., ISBN 80-239-4862-8.
13. McKENZIE, R., MAY, S.: The cervical & thoracic spine mechanical diagnosis & therapy. 1. diel, 2. vydanie, New Zealand, Spinal Publications New Zealand Ltd, 2006, s. 564, ISBN 13 978-0-9583647-7-5.
14. McKENZIE, R., MAY, S.: The cervical & thoracic spine mechanical diagnosis & therapy. 2. diel, 2. vydanie, New Zealand, Spinal Publications New Zealand Ltd, 2006, s. 564, ISBN 13 978-0-9583647-7-5.
15. NOVÁKOVÁ, E., MALIŠKA, L. ILIAŠOVÁ, M.: Terapie bederní páteře přístupem Robina McKenzie. 2001, 68 s., ISBN 80-238-7047-5.
16. NOVÁKOVÁ, E., ŘÍHA, M., ŠOLCOVÁ, H., LETÁKOVÁ, J., HACKEL, M.: Postačí dostupné zobrazovací metody při výhřezu meziobratlové ploténky ke stanovení klinické diagnózy? Rozvaha z pohledu kliniků zabývajících se problematikou vertebrogenních onemocnění. Rehabilitačná Medicína & Fyzioterapia, 2012, č. 2, s. 34-42.
17. PÁNEK, D., JURÁK, D., PAVLŮ, D., KRAJČA, V., ČESMUSOVÁ, J.: Metodika snímaní povrchové EMG ve vodním prostředí. Rehabilitace a fyzikální lékařství, 17, 2010, 1, s. 21-25, ISSN 1211 – 2658.
18. PASCAL, M., FREDERIC, L., LARS, AN., PHILIPPE, R., DARIO, F.: Experimental muscle pain changes the spatial distribution of upper trapezius muscle activity during sustained contraction. In: Clinical Neurophysiology [online], roč. 117, 2006, č. 11, s. 2436-2445.
19. PAVLŮ, D., PÁNEK, D.: EMG analýza vybraných svalů horní končetiny při pohybu ve vodním prostředí a pohybu proti odporu elastického tahu. Rehabilitace a fyzikální lékařství, roč. 15, 208, č. 4, s. 167-173, ISSN 1211 – 2658.
20. PAVLŮ, D., PÁNEK, D., LOUČKOVÁ, Z., MUSÁLEK, M.: Vliv cvičení s vibrační činkou na aktivitu m. trapezius. Rehabilitace a fyzikální lékařství, roč. 19, 2012, č. 1, s. 30, ISSN 1211 – 2658.
21. PETTY, N. J., MOORE, A. P.: Principles of neuromusculoskeletal treatment and management. Churchill Livingstone, 2004, s. 171-174, ISBN 0443070628.
22. PULLMAN, S. L., GOODIN, D. S., MARQUINEZ, A. I., TABBAL, S., RUBIN, M. D.: Clinical utility of surface EMG report of the therapeutics and technology assessment, subcommittee of the American Academy of Neurology. Neurology, 55, 2000, s. 171-177.
23. SJORS, A., LARSSON, B., DAHLMAN, J., FALKMER, T., GERDLE, B.: Physiological responss to low-force work and psychosocial stress in women with chronic trapezius myalgia. In: BMC Musculoskelet. Disord., [online], roč. 10, 2009, s. 63.
24. SOMMERICH, C. M., SHARON, M. B., JOINES, HERMANS, V., MOON, S. D.: Use of surface electromyography to estimate neck muscle activity - review, [online]. Journal of Electromyography and Kinesiology, roč. 10, 2000, s. 377-398.
25. VÉLE, F.: Kineziologie. Triton, 2006, s. 211, ISBN 80-7254 – 837 – 9.
26. VERNON, H., MIOR, S.: The Neck Disability Index: A study of reliability and validity. Journal of Manipulative and Physiological Therapeutics, 14, 1991, s. 409-415.
27. VOERMAN, G. E., VOLLENBROEK-HUTTEN, M. M., HERMENS, H. J.: Upper trapezius muscle activation patterns in neck-shoulder pain patients and healthy controls. Eur J. Appl. Physiol., 102, 2007, 1, s. 1-9.
Labels
Physiotherapist, university degree Rehabilitation Sports medicineArticle was published in
Rehabilitation and Physical Medicine
2013 Issue 2
Most read in this issue
- Relation of the Heel Valgosity, Typology and Biomechanics of the Foot in Children
- What Should Physiotherapist Know about Carpal Instability?
- McKenzie Method in Combination with (as a part of) the Classic Physiotherapy in the Treatment of Patients with Chronic Pain in the Cervical Region of the Spine
- Quantifying the Influence of Vacuum-compression Therapy on the Direct Increase of Oxygen Supply in the Treated Extremity