Comparison Between Proprioceptive Neuromuscular Facilitation and Mckenzie Method in Lumbar Range of Motion on Non-Specific Low Back Pain
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Abstract
One of activity that contributed to non-specific low back pain (LBP) is prolonged sitting. Therapeutic exercise that commonly used for management of non-specific LBP is McKenzie method while the Proprioceptive Neuromuscular Facilitation (PNF) exercise was rarely used for non-specific LBP. The purpose of the study is to find the effect of PNF and McKenzie method in lumbar range of motion (ROM) on non-specific LBP. A quasi-experimental study involving 36 subjects (students and staffs) from the university population. The subjects were assigned to three treatment groups: PNF group, McKenzie group and control group (hot pack and educational home exercise sheet) which underwent 12 treatment sessions distributed over three times in a week for four weeks duration. Subjects were measured on lumbar flexion and extension ROM by modified schober method. Measurement was performed at three points: pre-test, mid-test and post-test. The within-between groups repeated measures ANOVA were used to analyse the effectiveness of PNF and McKenzie treatments based on the measurement time. This study showed each treatment has significant improvement lumbar flexion ROM (p<0.05) and extension ROM (p<0.05) after 4 weeks. However, there is no significant difference between PNF and McKenzie method in increasing lumbar flexion ROM (p=0.100) and extension ROM (p=0.127) after 4 weeks. The study findings showed that the PNF exercise and McKenzie method has no difference in improving of lumbar ROM on non-specific LBP subjects.
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References
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Arya, R.K. 2014.Low Back Pain-Sign, symptoms, and management. Journal Indian Academy of Clincal Medicine 15 (1)
Aziz, S., Ilyas, S., Imran S., Yamin F., Zakir A., Rehman A., Adnan S., Khanzada S. (2016). Effectiveness of McKenzie Exercise in Reducing Neck and Back Pain Among Madrassa Student. International Journal Physiotherapy 3 (1), 78-85
Bardin L, D., King P., Maher C, D. (2017). Diagnostic triage for low back pain : a practical approach for primary care. The Medical Journal Australia 206 6. doi: 10.5694/mja16.00828
Casas, A.S., Patino, M.S., Camargo, D.M. (2016). Association between the sitting posture and back pain in college student. Revista de la Universidad Industrial de Santander. Salud 48(4)
Casser HR, Seddigh S, Rauschmann M. (2016). Acute lumbar back pain—investigation, differential diagnosis and treatment. Deutsches Ärzteblatt International 113: 223 34. DOI: 10.3238/arztebl.0223
Castellini, G., Gianola, S., Banfi, G., Bonovas, S., & Moja, L. (2016). Mechanical low back pain: Secular trend and intervention topics of randomized controlled trials. Physiotherapy Canada 68 (1), 61–63. https://doi.org/10.3138/ptc.2014-58
Chhaya, V., Renuka D., Vijaya K., Amol B. (2015). Lumbar range of motion : Reliability between schober’s test and modified schober’s test. Romanian Journal of Physical Therapy .(21)35
Clare H, Adams R and Maher CG .(2004). A systematic review of efficacy of McKenzie therapy for spinal pain. Australian Journal of Physiotherapy 50: 209–216]
Damanhuri, Z., Zulkifli A., Lau, A.C. T., Zainuddin, H. (2014). Low back pain among office workers in a public university in Malaysia. International journal of Public Health and Clinical Sciences 1: No. 1
Delitto, A., George, S., van Dillen, L., Whitman J., Sowa G., Shekelle P…. Godges, J, J. (2012). Low back pain : clinical practice guidelines linked to the international classification of functioning disability, and health from the orthopaedic section of the American Physical Therapy Association. Journal of orthopaedic and sport physical therapy. 42 (4). doi:10.2519/jospt.2012.0301
Dhaliwal, M. K., Amandeep , Jagmohan., Manjeet. (2014). To compare the effect of proprioceptive neuromuscular facilitation program versus core stabilization exercise for decreasing pain and improving function in patients with low back pain. IOSR Journal of sport and physical education 1. PP 29-35
El-Bandrawy, A. M., Ghareeb, H. O. (2016). Influence of McKenzie protocol in postmenopausal low back pain, International Journal of Therapeutic Applications 33, 20-27. http://dx.doi.org/10.20530/IJTA_33_20-27
Franklin, C.V.J., Kalirathinam, D., Palekar T., Nathani N. (2013). Effectiveness of PNF Training for Cronic Low Back Pain. IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2 (41-52)
Garcia, A.N., Gondo, F.L.B., Costa, R.A., Cyrillo, F.N., Costa, L.O.P. (2011). Effects of two physical therapy interventions in patients with chronic non-specific low back pain : feasibility of a randomized controlled trial. Revista Brasileira Fisioterapia, Sao Carlos 15, n.5, p.420-7
Gawda P, Dmoszyńska-Graniczka M, Pawlak H, Cybulski M, Kiełbus M, Majcher P, Buczaj A, Buczaj M. (2015). Evaluation of influence of stretching therapy and ergonomic factors on postural control in patients with chronic non-specific low back pain. Annals of Agricultural and Environmental Medicine 22(1): 142–146. doi: 10.5604/12321966.1141384
Gordon, R., Bloxham, S. (2016). A sytematic review of the effects of exercise and physical activity on non-specific cronic low back pain, Healthcare journal 4, 22; 10.3390
Hasanpour-Dehkordi, A., Dehghani, A., Solati, K. 2017. A comparison of the effects of Pilates and McKenzie training on pain and general health in men with chronic low back pain: A randomized trial. Indian Journal of Palliative Care. 23:36-40. DOI: 10.4103/0973-1075.197945
Issa LF,. Seleem NA,. Bakheit AM,. Baky AA,. Alotaibi AF,. 2016. Low back pain among undergraduate student at Taif University- Saudi Arabia. International Journal of Public Health and Epidemiology 5 (6), pp 275-284
Jadeja, T., Vyas, N., Sheth, M. (2015). To Study the effect of proprioceptive neuromuscular facilitation on back muscle strength, pain, and quality of life in subjects with chronic low back pain-an experimental study. International Journal of Physiotherapy 2(5), 778 -785
Johnson GS., Johnson VS.(2002). The application of the principles and procedures of PNF for the care of lumbar spinal disabilities. The journal of manual and manipulative therapy 10. No. 2. 83-105
Koes B, W., van Tulder M., Lin, C., Macedo, L, G., McAuley J., Maher C. (2010). An update overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal 19 : 2075-2094. DOI 10.1007/s00586-010-1502-y
Kofotolis, N., Kellis, E. (2006). Effect of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional outcomes performance in women with chronic low back pain. Physical Therapy 86 (7): 1001-1012
Koley S, Kaur J, Sandhu JS.2010. Biological risk indicators for non-specific low back pain in young adults of Amritsar, Punjab, India. Journal of Life Sciences 2:43-48.
Koley S, Sharma L, Kaur S.(2010). Effects of occupational exposure to whole body vibration in tractor drivers with low back pain in Punjab. Anthropologist 12:183-187
Kumar A., Zutshi K,. Narang N. Efficiacy of Trunk Propioceptive Neuromuscular Facilitation Training on Chronic Low Back Pain. International Journal of Sports Science and Engineering 2011; Vol. 5 (3), pp. 174-180
Kuppusamy, S., Narayanasamy R., and Christopher, J, D. (2013). Effectiveness of McKenzie Exercise and Mat based Pilates exercise in subjects with chronic non-specific low back pain : a comparative study. International Journal of Prevention and Treatment 2 (4) : 47-54
Lee A, S., Cholewicki, J., Reeves N, P, Zazulak B,T., Mysliwiec, L, W. (2010). Comparison of Trunk Proprioception Between Patients With Low Back Pain and Healthy Controls. Archives of Physical Medicine and Rehabilitation Vol 91 (9):1327-1331
Lee YJ. (2009).The effects of the PNF Techniques on lumbar stability and the functional activity in chronic low back pain patients. Department of Physical Therapy Graduate School of Dongshin University, pp 1–60
Lee, C.-W., Hwangbo, K., & Lee, I.-S. (2014). The effects of combination patterns of proprioceptive neuromuscular facilitation and ball exercise on pain and muscle activity of chronic low back pain patients. Journal of Physical Therapy Science 26(1), 93–6. https://doi.org/10.1589/jpts.26.93
Maher, C., Underwood, M., Butchbindee, R. (2017). Non-specific low back pain. Seminar, Lancet 389: 736-47
McKenzie, R. (2011). Treat your own back. Ninth Edition. New Zealand. Spinal Publications New Zealand Ltd.
Mozafari, A., Vahedian, M., Mohebi, S., Najafi M. (2015). Work-related Musculosceletal disorder in truck drivers and office worker. Acta medica Iranica, 53, No. 7
Nordin, N. A., Devinder, A. S., & Kanglun, L. (2014). Low Back Pain and Associated Risk Factors among Health Science Undergraduates. Sains Malaysiana 43(3), 423–428. Retrieved from http://www.ukm.my/jsm/pdf_files/SM-PDF-43-3-2014/12 Nor Azlin Mohd Nordin.pdf
Norkin C, C,. White D, J. (2003). Measurement of Joint Motion : A guide to goniometry, Third Edition. FA Davis, Philadelphia
Paatelma, M., Kiplikoski, S., Simonen, R., Heinonen, A., Alen, M., Videman, T. (2008). Orthopedic manual therapy, McKenzie method or advice only for low back pain in working adults : A Randomised controlled trial with one year follow-up. Journal of Rehabilitation Medicine 40: 858-863
Park, K.Y., Seo, K.Y.(2014). The Effects on the pain index and lumbar flexibility of obese patients with low back pain after PNF Scapular and PNF pelvic patterns, Journal of Physical Therapy Scienes 26 : 1571-1574
Park, S. E., Wang, J.S. (2015). Effect of joint mobilization KEOMT and PNF on a patient with CLBP and a lumbar transitional vertebra : a case study, Journal of Physical Therapy Sciences 27 : 1629-1632
Reese, N., Bandy, W. (2002). Joint Range of Motion and Muscle Length Testing. Saunders Company. Philadelphia, USA
Scharrer M, Ebenbichler G, Peiber K, Crevenna, Gruther W, Zorn C, Grimm- Steiger, Herceg M, Keilani M, Ammer K.(2012). Asystematic review on the effectiveness of medical training therapy for subacute and chronic low back pain. European Journal Phyhsical Rehabilitation Medicine 48: 361-70
Sihawong R., Sitthipornvorakul, E., Paksaichol, A., Janwantanakul P. Predictors for chronic neck and low back pain in office workers : a 1-year prospective cohort study. J Occup Health 2016; 58, 6-24.
Sihawong, R., Janwantanakul, P., & Jiamjarasrangsi, W. (2014). A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers. European Spine Journal 23(4), 786–793. https://doi.org/10.1007/s00586-014-3212-3
Taguchi, T. (2003). Low back pain in young and middle-aged people. Journal of Japan Medical Association. JMAJ 46(10): 417–423
Tarek, F., Osama, F., A. Mohamed, S., Ragia, M., K. (2017). Effect of low level laser versus McKenzie technique in treatment of chronic low back pain, Journal of Bioengineer & Biomedical Sciences 7: 2, DOI: 10.4172/2155-9538.1000228
Waongenngarm, P., Rajaratnam, B. S., & Janwantanakul, P. (2016). Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Safety and Health at Work 7(1), 49–54. https://doi.org/10.1016/j.shaw.2015.08.001
Westwater-Wood, S., Adam N., Kerry, R. (2010). The use of proprioceptive neuromuscular facilitation in physiotherapy practice. Physical Therapy Reviews 15 (1). DOI 10.1179/174328810X12647087218677
Wong, T, K, T and Lee, R, Y, W. (2004). Effect of low back pain on the relationship between the movements of lumbar spine and hip. Human Movement Science 23 : 21-34. doi:10.1016/j.humov.2004.03.004
Arya, R.K. 2014.Low Back Pain-Sign, symptoms, and management. Journal Indian Academy of Clincal Medicine 15 (1)
Aziz, S., Ilyas, S., Imran S., Yamin F., Zakir A., Rehman A., Adnan S., Khanzada S. (2016). Effectiveness of McKenzie Exercise in Reducing Neck and Back Pain Among Madrassa Student. International Journal Physiotherapy 3 (1), 78-85
Bardin L, D., King P., Maher C, D. (2017). Diagnostic triage for low back pain : a practical approach for primary care. The Medical Journal Australia 206 6. doi: 10.5694/mja16.00828
Casas, A.S., Patino, M.S., Camargo, D.M. (2016). Association between the sitting posture and back pain in college student. Revista de la Universidad Industrial de Santander. Salud 48(4)
Casser HR, Seddigh S, Rauschmann M. (2016). Acute lumbar back pain—investigation, differential diagnosis and treatment. Deutsches Ärzteblatt International 113: 223 34. DOI: 10.3238/arztebl.0223
Castellini, G., Gianola, S., Banfi, G., Bonovas, S., & Moja, L. (2016). Mechanical low back pain: Secular trend and intervention topics of randomized controlled trials. Physiotherapy Canada 68 (1), 61–63. https://doi.org/10.3138/ptc.2014-58
Chhaya, V., Renuka D., Vijaya K., Amol B. (2015). Lumbar range of motion : Reliability between schober’s test and modified schober’s test. Romanian Journal of Physical Therapy .(21)35
Clare H, Adams R and Maher CG .(2004). A systematic review of efficacy of McKenzie therapy for spinal pain. Australian Journal of Physiotherapy 50: 209–216]
Damanhuri, Z., Zulkifli A., Lau, A.C. T., Zainuddin, H. (2014). Low back pain among office workers in a public university in Malaysia. International journal of Public Health and Clinical Sciences 1: No. 1
Delitto, A., George, S., van Dillen, L., Whitman J., Sowa G., Shekelle P…. Godges, J, J. (2012). Low back pain : clinical practice guidelines linked to the international classification of functioning disability, and health from the orthopaedic section of the American Physical Therapy Association. Journal of orthopaedic and sport physical therapy. 42 (4). doi:10.2519/jospt.2012.0301
Dhaliwal, M. K., Amandeep , Jagmohan., Manjeet. (2014). To compare the effect of proprioceptive neuromuscular facilitation program versus core stabilization exercise for decreasing pain and improving function in patients with low back pain. IOSR Journal of sport and physical education 1. PP 29-35
El-Bandrawy, A. M., Ghareeb, H. O. (2016). Influence of McKenzie protocol in postmenopausal low back pain, International Journal of Therapeutic Applications 33, 20-27. http://dx.doi.org/10.20530/IJTA_33_20-27
Franklin, C.V.J., Kalirathinam, D., Palekar T., Nathani N. (2013). Effectiveness of PNF Training for Cronic Low Back Pain. IOSR Journal of Nursing and Health Science (IOSR-JNHS) 2 (41-52)
Garcia, A.N., Gondo, F.L.B., Costa, R.A., Cyrillo, F.N., Costa, L.O.P. (2011). Effects of two physical therapy interventions in patients with chronic non-specific low back pain : feasibility of a randomized controlled trial. Revista Brasileira Fisioterapia, Sao Carlos 15, n.5, p.420-7
Gawda P, Dmoszyńska-Graniczka M, Pawlak H, Cybulski M, Kiełbus M, Majcher P, Buczaj A, Buczaj M. (2015). Evaluation of influence of stretching therapy and ergonomic factors on postural control in patients with chronic non-specific low back pain. Annals of Agricultural and Environmental Medicine 22(1): 142–146. doi: 10.5604/12321966.1141384
Gordon, R., Bloxham, S. (2016). A sytematic review of the effects of exercise and physical activity on non-specific cronic low back pain, Healthcare journal 4, 22; 10.3390
Hasanpour-Dehkordi, A., Dehghani, A., Solati, K. 2017. A comparison of the effects of Pilates and McKenzie training on pain and general health in men with chronic low back pain: A randomized trial. Indian Journal of Palliative Care. 23:36-40. DOI: 10.4103/0973-1075.197945
Issa LF,. Seleem NA,. Bakheit AM,. Baky AA,. Alotaibi AF,. 2016. Low back pain among undergraduate student at Taif University- Saudi Arabia. International Journal of Public Health and Epidemiology 5 (6), pp 275-284
Jadeja, T., Vyas, N., Sheth, M. (2015). To Study the effect of proprioceptive neuromuscular facilitation on back muscle strength, pain, and quality of life in subjects with chronic low back pain-an experimental study. International Journal of Physiotherapy 2(5), 778 -785
Johnson GS., Johnson VS.(2002). The application of the principles and procedures of PNF for the care of lumbar spinal disabilities. The journal of manual and manipulative therapy 10. No. 2. 83-105
Koes B, W., van Tulder M., Lin, C., Macedo, L, G., McAuley J., Maher C. (2010). An update overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal 19 : 2075-2094. DOI 10.1007/s00586-010-1502-y
Kofotolis, N., Kellis, E. (2006). Effect of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional outcomes performance in women with chronic low back pain. Physical Therapy 86 (7): 1001-1012
Koley S, Kaur J, Sandhu JS.2010. Biological risk indicators for non-specific low back pain in young adults of Amritsar, Punjab, India. Journal of Life Sciences 2:43-48.
Koley S, Sharma L, Kaur S.(2010). Effects of occupational exposure to whole body vibration in tractor drivers with low back pain in Punjab. Anthropologist 12:183-187
Kumar A., Zutshi K,. Narang N. Efficiacy of Trunk Propioceptive Neuromuscular Facilitation Training on Chronic Low Back Pain. International Journal of Sports Science and Engineering 2011; Vol. 5 (3), pp. 174-180
Kuppusamy, S., Narayanasamy R., and Christopher, J, D. (2013). Effectiveness of McKenzie Exercise and Mat based Pilates exercise in subjects with chronic non-specific low back pain : a comparative study. International Journal of Prevention and Treatment 2 (4) : 47-54
Lee A, S., Cholewicki, J., Reeves N, P, Zazulak B,T., Mysliwiec, L, W. (2010). Comparison of Trunk Proprioception Between Patients With Low Back Pain and Healthy Controls. Archives of Physical Medicine and Rehabilitation Vol 91 (9):1327-1331
Lee YJ. (2009).The effects of the PNF Techniques on lumbar stability and the functional activity in chronic low back pain patients. Department of Physical Therapy Graduate School of Dongshin University, pp 1–60
Lee, C.-W., Hwangbo, K., & Lee, I.-S. (2014). The effects of combination patterns of proprioceptive neuromuscular facilitation and ball exercise on pain and muscle activity of chronic low back pain patients. Journal of Physical Therapy Science 26(1), 93–6. https://doi.org/10.1589/jpts.26.93
Maher, C., Underwood, M., Butchbindee, R. (2017). Non-specific low back pain. Seminar, Lancet 389: 736-47
McKenzie, R. (2011). Treat your own back. Ninth Edition. New Zealand. Spinal Publications New Zealand Ltd.
Mozafari, A., Vahedian, M., Mohebi, S., Najafi M. (2015). Work-related Musculosceletal disorder in truck drivers and office worker. Acta medica Iranica, 53, No. 7
Nordin, N. A., Devinder, A. S., & Kanglun, L. (2014). Low Back Pain and Associated Risk Factors among Health Science Undergraduates. Sains Malaysiana 43(3), 423–428. Retrieved from http://www.ukm.my/jsm/pdf_files/SM-PDF-43-3-2014/12 Nor Azlin Mohd Nordin.pdf
Norkin C, C,. White D, J. (2003). Measurement of Joint Motion : A guide to goniometry, Third Edition. FA Davis, Philadelphia
Paatelma, M., Kiplikoski, S., Simonen, R., Heinonen, A., Alen, M., Videman, T. (2008). Orthopedic manual therapy, McKenzie method or advice only for low back pain in working adults : A Randomised controlled trial with one year follow-up. Journal of Rehabilitation Medicine 40: 858-863
Park, K.Y., Seo, K.Y.(2014). The Effects on the pain index and lumbar flexibility of obese patients with low back pain after PNF Scapular and PNF pelvic patterns, Journal of Physical Therapy Scienes 26 : 1571-1574
Park, S. E., Wang, J.S. (2015). Effect of joint mobilization KEOMT and PNF on a patient with CLBP and a lumbar transitional vertebra : a case study, Journal of Physical Therapy Sciences 27 : 1629-1632
Reese, N., Bandy, W. (2002). Joint Range of Motion and Muscle Length Testing. Saunders Company. Philadelphia, USA
Scharrer M, Ebenbichler G, Peiber K, Crevenna, Gruther W, Zorn C, Grimm- Steiger, Herceg M, Keilani M, Ammer K.(2012). Asystematic review on the effectiveness of medical training therapy for subacute and chronic low back pain. European Journal Phyhsical Rehabilitation Medicine 48: 361-70
Sihawong R., Sitthipornvorakul, E., Paksaichol, A., Janwantanakul P. Predictors for chronic neck and low back pain in office workers : a 1-year prospective cohort study. J Occup Health 2016; 58, 6-24.
Sihawong, R., Janwantanakul, P., & Jiamjarasrangsi, W. (2014). A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers. European Spine Journal 23(4), 786–793. https://doi.org/10.1007/s00586-014-3212-3
Taguchi, T. (2003). Low back pain in young and middle-aged people. Journal of Japan Medical Association. JMAJ 46(10): 417–423
Tarek, F., Osama, F., A. Mohamed, S., Ragia, M., K. (2017). Effect of low level laser versus McKenzie technique in treatment of chronic low back pain, Journal of Bioengineer & Biomedical Sciences 7: 2, DOI: 10.4172/2155-9538.1000228
Waongenngarm, P., Rajaratnam, B. S., & Janwantanakul, P. (2016). Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Safety and Health at Work 7(1), 49–54. https://doi.org/10.1016/j.shaw.2015.08.001
Westwater-Wood, S., Adam N., Kerry, R. (2010). The use of proprioceptive neuromuscular facilitation in physiotherapy practice. Physical Therapy Reviews 15 (1). DOI 10.1179/174328810X12647087218677
Wong, T, K, T and Lee, R, Y, W. (2004). Effect of low back pain on the relationship between the movements of lumbar spine and hip. Human Movement Science 23 : 21-34. doi:10.1016/j.humov.2004.03.004