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Effets a court terme d'un traitement selon la "preference directionnelle" de patients lombalgiques: essai controle randomise (Short-time effects of a treatment according to the "directional preference" of low back pain patients: a randomized clinical trial) [French; with consumer summary]
Bonnet F, Monnet S, Otero J
Kinesitherapie La Revue 2011 Apr;11(112):51-59
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: Guidelines recommend therapeutic exercises as a treatment for non-specific low back pain in a generic way, without specifications. The McKenzie method uses a classification system to determine a specific exercise program performed in a particular direction of motion called "directional preference". PROTOCOL: Randomized controlled trial. METHOD: A total of 54 patients randomly assigned in two groups were treated either according to McKenzie's principles of treatment, or according to the guidelines recommendations. Initial and final assessments were done on the same week, which included 3 sessions of care. Outcomes were Oswestry scale, pain location and pain intensity. RESULTS: 62.5% of the test group's patients modified in a distal to proximal manner the pain location (centralization) versus 16.7% of the control group (p = 0.008). Others outcomes were not significantly improved. CONCLUSION: The use of a directional preference allows a significant modification of the pain location in a distal to proximal manner compared to a reference treatment. Three sessions of care spread over only one week do not significantly improve others outcomes.

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