Пока ожидаются результаты этого исследования, систематические обзоры по теме имеют разные выводы, вот как комментирует сам Маккензи:
I would like to congratulate Machado et al1 on their systematic review of the McKenzie method. These reviewers have demonstrated knowledge that the McKenzie method is based on assessment findings and subclassification. The review recognizes that the McKenzie method is not just extension exercises, a point so often overlooked by both clinical investigators and even systematic reviewers, such as van Tulder et al.2 Machado et al1 make some important points about the value of a classification-based approach to the treatment of back pain and the strength of validity of this approach.
The review recognizes the careless application of the “McKenzie” method when a proper classification approach has not been used. However, the authors then make the same error, calling standardized use of extension exercises “generic McKenzie.” The method has always been based on assessment and classification; anything else is not McKenzie.
A previous systematic review 3 came to similar conclusions, but the most striking difference between the 2 reviews relates to the included studies. Clare et al3 had strict inclusion/exclusion criteria to take account of the fact that a careless description of a trial intervention as “McKenzie” did not mean that patients’ McKenzie classification was actually considered in treatment assignment. Seven studies included by Machado et al1 were specifically excluded by Clare et al,3 as they did not represent proper McKenzie treatment.
Subgroup classification of back pain seems the most promising way to get beyond the trivial effects and minimal differences that we have become used to, both from randomized controlled trials and systematic reviews, such as this one.
Robin A. McKenzie, CNZM, OBE, FNZSP (Hon), FCSP (Hon)
Department of Rehabilitation
The McKenzie Institute International
Raumati Beach, New Zealand
References
1. Machado LA, de Souza MS, Ferreira PH, et al. The McKenzie method for low back pain: A systematic review of the literature with a meta-analysis approach. Spine 2006;31:E254–62.
2. van Tulder M, Malmivaara A, Esmail R, et al. Exercise therapy for low back pain: A systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2000;25:2784–96.
3. Clare HA, Adams R, Maher CG. A systematic review of efficacy of McKenzie therapy for spinal pain. Aust J Physiother 2004;50:209–16.
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