COMPARATIVE EFFECTS OF MCKENZIE THERAPY AND CORE STABILIZATION EXERCISES ON PAIN, DISABILITY, AND FUNCTIONAL OUTCOMES IN PATIENTS WITH CHRONIC NONSPECIFIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Chronic nonspecific low back pain (CNSLBP) is a common musculoskeletal condition associated with persistent pain, functional disability, and reduced physical performance. McKenzie therapy and core stabilization exercises are widely used physiotherapy interventions; however, their comparative effectiveness across different clinical and functional outcomes remains unclear.

Objective: To compare the effects of McKenzie therapy and core stabilization exercises on pain intensity, functional disability, and functional performance in patients with chronic nonspecific low back pain.

Methods: A two-arm, parallel-group randomized controlled trial was conducted at IIMCT–Railway General Hospital, Rawalpindi, Pakistan, from March 2024 to August 2024. A total of 60 participants with chronic nonspecific low back pain were allocated into two groups. Group A (n = 30) received McKenzie therapy, while Group B (n = 30) received core stabilization exercises. Both groups underwent supervised interventions for six weeks, with three sessions per week, lasting approximately 45 minutes per session. Pain intensity, functional disability, and functional performance were assessed before and after the intervention using the Numeric Pain Rating Scale (NPRS), Modified Oswestry Disability Index (MODI), and Five Times Sit-to-Stand Test (5×STS), respectively. Data was analyzed using IBM SPSS Statistics version 27, with statistical significance set at p less than 0.05.

Results: Both intervention groups demonstrated statistically significant improvements in all three outcome measures following the six-week treatment program (p less than 0.001). McKenzie therapy produced a greater reduction in pain intensity, with NPRS scores decreasing from 6.85 ± 1.15 to 2.35 ± 0.95, compared with 6.70 ± 1.20 to 3.15 ± 1.10 in the core stabilization group (p = 0.002). Similarly, functional disability improved more in the McKenzie group, with MODI scores decreasing from 41.2 ± 8.1% to 15.8 ± 6.2%, compared with 40.5 ± 7.9% to 20.4 ± 6.8% in the core stabilization group (p = 0.003). Conversely, core stabilization exercises produced greater improvement in functional performance, with 5×STS completion time decreasing from 16.1 ± 3.2 to 10.8 ± 2.5 seconds, compared with 16.4 ± 3.4 to 12.9 ± 2.9 seconds in the McKenzie group (p = 0.008).

Conclusion: Both McKenzie therapy and core stabilization exercises were effective in improving pain intensity, functional disability, and functional performance in patients with chronic nonspecific low back pain. McKenzie therapy demonstrated greater effectiveness in reducing pain and functional disability, whereas core stabilization exercises produced greater improvements in functional performance. Both interventions may be considered valuable physiotherapy approaches, with treatment selection guided by individual patient needs and rehabilitation goals.