Efficacy of a multimodal therapeutic exercise program in shellfish gatherers for the prevention of musculoskeletal disorders: a quasi-experimental study.

AIM: Aim of the present study was to determine the efficacy of a therapeutic exercise program to modify the muscular endurance of the trunk, the localization and intensity of musculoskeletal pain, fear-avoidance beliefs, perceived change after the treatment and satisfaction. METHODS: The present study has a quasi-experimental design (N.=19) with measurements taken before and after 16 sessions. The measures included: trunk extensors and flexors endurance, localization and intensity of pain and fear avoidance behavior. At the end of the program the perception of changes at musculoskeletal level and satisfaction were also obtained. Statistical analysis was carried out using Student's T-test for paired data, Wilcoxon's test and McNemar's test. The study was approved by the Ethics Committee and the patients gave their informed consent. RESULTS: The 94% were women with a mean age of 58 years. The 42.1% had musculoskeletal pain, with the most frequent locations being the lower back, neck and shoulder regions. A significant increase in the muscular endurance of the trunk extensors and flexors (in seconds) was detected; (67.1±42 vs. 96.1±55.2) (P=0.005) and (28.2±18.3 vs. 67.8±41.1) (P=0.000), respectively. A decrease that was close to statistical significance (P=0.19) was observed in the score on the FABQ (53.9±18.8 vs. 48±19.7). The prevalence of lower back pain (84.2% vs. 47.4%; P=0.016) and upper back pain (42.1% vs. 10.5%; P=0.031) decreased significantly after the treatment. The 78.4% had improved and 89.5% were very satisfied with the treatment. CONCLUSION: The treatment increased the muscular endurance of both the trunk extensors and flexors. A decrease in the prevalence of lower back, upper back and neck pain was observed. The perceived change and satisfaction were high.

Evidencia en el manejo del dolor de espalda crónico con el método McKenzie / Evidence in the management of chronic back pain with the McKenzie method

Objetivo Revisar la evidencia científica publicada sobre el método McKenzie en dolor lumbar. Estrategia de búsqueda Búsqueda en la base de datos Medline, en la página web del Instituto McKenzie y análisis de la evidencia publicada por May y Donelson (2008). Selección de estudios y datos Se limita la búsqueda a los últimos 5 años. Se realiza una búsqueda inversa y un filtrado manual centrado en extraer resultados estrechamente relacionados con la temática de búsqueda y en función del nivel de evidencia de los artículos. Síntesis de resultados Se encuentra evidencia sobre diversos aspectos del método McKenzie: fiabilidad interobservador como método exploratorio, especificidad del fenómeno de centralización y eficacia comparado con otros tratamientos. Conclusiones El método McKenzie presenta eficacia similar a los ejercicios de estabilización y una tendencia favorable comparándolo con los ejercicios de fortalecimiento. El fenómeno de centralización tiene valor pronóstico positivo. Presenta una alta fiabilidad como método de exploración(AU)

Objective To review the scientific evidence published on the McKenzie method for back pain. Research strategy A search was made in the Medline database, and on the McKenzie Institute website, and the evidence published by May and Donelson (2008) was analyzed. Studies and data selection The search was limited to the last five years. A reverse search and a manual filtering (as a function of the level of evidence) focused on extracting results closely related to the subject under research were performed. Results summary Evidence on the different aspects of the McKenzie method has been found: inter-examiner reliability as exploratory method, specificity of the centralization phenomenon, and effectiveness compared to other treatments. Conclusions The McKenzie method has similar effectiveness as that of stabilization exercises with a favorable tendency in comparison with strengthen-building exercises. The centralization phenomenon has a positive prognostic value. The method present high reliability as an exploratory method(AU)