DOI QR코드

DOI QR Code

요통 환자를 위한 멕켄지의 역학적 증후군 진단 : 역학적 부하 전략을 중심으로

Diagnosis of McKenzie Mechanical Syndromes for Patient with Low Back Pain : Focused on mechanical loading strategies

  • 김민희 (고려대학교 의과대학 인간행동과 유전자연구소)
  • Kim, Minhee (Human Behavioral & Genetic Institute, associate Research Center, Korea University)
  • 투고 : 2018.11.30
  • 심사 : 2018.12.26
  • 발행 : 2018.12.31

초록

Purpose: McKenzie is a widely-used and conventional clinical therapeutic exercise for patients with mechanical lower back pain. It is a well-designed assessment and classification system for the spine. Main issue: Patients with mechanical lower back pain are classified into one of three mechanical syndromes (posture, dysfunction, or derangement syndrome) by mechanical loading strategies. These methods evaluate symptomatic and mechanical responses during repeated end-range movement and sustained postures. The goal of McKenzie mechanical syndrome diagnosis is to determine directional preferences. Directional preference is a phenomenon of preference for posture or movement in one direction, which reduces or centralizes pain. However, in Korea, there is a lack of awareness of basic McKenzie mechanical syndromes diagnostic concepts. Koreans tend to think of the McKenzie method as a simple lumbar extension exercise. However, an accurate diagnosis of a mechanical syndrome must precede the application of McKenzie exercise. Conclusions: Thus, in this study, I present a classification method of McKenzie mechanical syndrome diagnosis and clinical characteristics of each mechanical syndrome.

키워드

참고문헌

  1. Danneels, L. A., Vanderstraeten, G. G., Cambier, D. C., Witvrouw, E. E., De Cuyper, H. J., & Danneels, L. (2000). CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. European Spine Journal, 9(4), 266-272. https://doi.org/10.1007/s005860000190
  2. Deyo, R. A., Mirza, S. K., & Martin, B. I. (2006). Back Pain Prevalence and Visit Rates. Spine, 31(23), 2724-2727. https://doi.org/10.1097/01.brs.0000244618.06877.cd
  3. Donelson, R., Aprill, C., Medcalf, R., & Grant, W. (1997). A prospective study of centralization of lumbar and referred pain: a predictor of symptomatic discs and anular competence. Spine, 22(10), 1115-1122. https://doi.org/10.1097/00007632-199705150-00011
  4. Garcia, A. N., Costa, L. C. M., ... da Silva, T. M. (2013). Effectiveness of back school versus McKenzie exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Physical therapy, 33(6), 729-749.
  5. Graves, J., Pollock, M., Carpenter, D., & Spine, S. L. (1990). Quantitative assessment of full range-of-motion isometric lumbar extension strength. Spine, 15(4), 289-294. https://doi.org/10.1097/00007632-199004000-00008
  6. Halliday, M. H., Pappas, E., Hancock, M. J., Clare, H. A., Pinto, R. Z., Robertson, G., & Ferreira, P. H. (2016). A Randomized Controlled Trial Comparing the McKenzie Method to Motor Control Exercises in People With Chronic Low Back Pain and a Directional Preference. Journal of Orthopaedic & Sports Physical Therapy, 46(7), 514-522. https://doi.org/10.2519/jospt.2016.6379
  7. Johannsen, F., Remvig, L., Kryger, P., Beck, P., Warming, S., Lybeck, K., ... Larsen, L. H. (1995). Exercises for Chronic Low Back Pain: A Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy, 22(2), 52-59. https://doi.org/10.2519/jospt.1995.22.2.52
  8. Lee, H. K., Cho, Y. H., & Lee, L. C. (2013). The effect of improve the waist flexibility, the waist muscular strength and the waist balance which grafted in William & Mckenzie exercise with swiss ball. Journal of the Korean Society of Physical Medicine, 8(4), 479-487. https://doi.org/10.13066/kspm.2013.8.4.479
  9. Long, A., Donelson, R., & Spine, T. F. (2004). Does it matter which exercise?: A randomized control trial of exercise for low back pain. Spine, 29(23), 2593-2602. https://doi.org/10.1097/01.brs.0000146464.23007.2a
  10. McKenzie, R. (2003). The lumbar spine : mechanical diagnosis and therapy. Spinal Publications.
  11. McKenzie, R., & Wijmen, P. Van. (1985). Treat your own back.
  12. Miller, E. R., Schenk, R. J., Karnes, J. L., & Rousselle, J. G. (2005). A Comparison of the McKenzie Approach to a Specific Spine Stabilization Program for Chronic Low Back Pain. Journal of Manual & Manipulative Therapy, 13(2), 103-112. https://doi.org/10.1179/106698105790824996
  13. Murtezani, A., Govori, V., Meka, V., Ibraimi, Z., Rrecaj, S., & Gashi, S. (2015). A comparison of mckenzie therapy with electrophysical agents for the treatment of work related low back pain: A randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 28(2), 247-253. https://doi.org/10.3233/BMR-140511
  14. Paatelma, M., Kilpikoski, S., Simonen, R., Heinonen, A., Alen, M., & Videman, T. (2008). Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working adults: a randomized controlled trial with one year follow-up. Journal of Rehabilitation Medicine, 40(10), 858-863. https://doi.org/10.2340/16501977-0262
  15. Shah, J., Hampson, W., & Jayson, M. (1978). The distribution of surface strain in the cadaveric lumbar spine. The Journal of Bone and Joint Surgery. British Volume, 60-B(2), 246-251. https://doi.org/10.1302/0301-620X.60B2.659474
  16. Turk, D., & Marcus, D. (1994)Assessment of chronic pain patients. Seminars in neurology, 14(3), 206-212. https://doi.org/10.1055/s-2008-1041079