Wybrane metody fizjoterapeutyczne: Metoda McKenziego.

Temat: Centralizacja bólu.

1. Al-Obaidi SM, Al-Sayegh NA, Nakhi HB, Skaria N., Effectiveness of McKenzie intervention in chronic low back pain: a comparison based on the centralization phenomenon utilizing selected bio-behavioral and physical measures, Int J Phys Med & Rehab, 2013;1:128 doi:10.4172/jpmr.1000128, 2013

Comparison of outcomes in 2 groups of patients with chronic low back pain who demonstrate COMPLETE (N =62) or partial centralization (N=43), and followed-up over 10 weeks with treatment with MDT. The groups were significantly different at baseline in terms of fear-avoidance and Roland-Morris Back Disability questionnaire. Over time both groups had highly significant changes in all outcomes relating to pain perception, fear beliefs, disability beliefs and physical performance tests, but were better in the full centralization group.

May S, Aina A, Centralization and directional preference: a systematic review., Manual Therapy, doi:10.1016/j.math.2012.05.003, 2012

The review included 54 studies relating to centralization and 8 relating to directional preference exercises. The prevalence on centralization was 44% in back and neck pain, with higher prevalence in acute (74%) than sub-acute or chronic symptoms (42%). Twenty-one of 23 studies supported the prognostic validity of centralization, whereas 2 did not. Centralization and directional preference appear to be useful treatment effect modifiers in 7 of 8 studies. Levels of reliability were very varied (kappa 0.15-0.9).

Kilpikoski S, Alen M, Simonen R, Heinonen A, Videman T., Does centralizing pain on the initial visit predict outcomes among adults with low back pain?, Manuelle therapie, 14:136-141, 2010

Secondary analysis of previous RCT (Paatelma et al. 2008) in which baseline centralizers (N=119) were compared to baseline non-centralizers (N=15) during follow-up. Centralizers had a significantly greater reduction in pain and disability immediately after the treatment period; and at 6 months for pain only. (In German)

Edmond SL, Werneke MW, Hart DL., Association between centralization, depression, somatization, and disability among patients with nonspecific low back pain., J Orthop Sports Phys Ther, 40:801-810, 2010

Secondary analysis of cohort study of 231 patients with back pain in which data was gathered about depression, somatization, and centralization at baseline, and measures of disability and pain at baseline and follow-up. Associations between depression and somatizisation and chronic disability were reduced in the presence of centralization.