Is McKenzie method with core exercise effective for Patients with disc derangement? A Case Series

Authors: Manjumala H Roy,Dr. Deepak Anap
VIMS Health Sci Journal: 2015; 2 (1):26-31 | 

Abstract

Background: McKenzie method is a common intervention for patients with Prolapse inter-vertebral disc (PIVD). Although this intervention sequence is effective but recurrence of symptoms is common, addition of core stabilization exercises will definitely give a permanent stability to disc thus reducing chances of recurrence. Purpose: Current study was done to see the combined effect of McKenzie with core muscle exercise in improving condition of disc herniation patient .Study Design : A case series of consecutive patients with Lumbar disc prolapse. Case Description: Four consecutive patients (mean age 38 years) who presented with prolapse intervertebral disc (PIVD) were treated with four weeks protocol which included McKenzie exercises along with lumbar core muscle stabilization exercises. All patients completed Visual analogue Scale (VAS), Manual Muscle Testing, spinal ranges and Quebec disability scale on initial assessment and at the end of intervention 4 weeks. Outcome: Post treatment outcome score showed reduction in VAS score 56% at rest and 55.30% during movement with improvement in muscle strength 33% improvement in back extension, 49.60% in lower abdominals, 50% in hip flexor strength and spinal ranges 44% improvement in lumbar flexion, 43% in extension 43% in side flexion right and 46% left respectively. Quebec disability score showed 65% reduction after treatment.Discussion: This case series describes the management and outcomes of patients diagnosed with lumbar disc prolapse treated with McKenzie with core muscle stabilization exercises. Patients demonstrated clinically meaningful decrease in pain, improved back muscle strength, improvement in spinal range of motion and decreased disability. However because a cause and effect relationship cannot be inferred from a case series, further studies in the form of well-designed, randomized clinical trials should be performed to evaluate the effectiveness of this protocol in patients with lumbar PIVD .Conclusions: McKenzie with core strengthening exercises reduces pain, improves strength, range of motion and reduces disability in PIVD subjects.