Effects of Mckenzie Exercise on Back Pain and Physical Fitness
Do-Jin Kim1, Jong-Hyuck Kim*2
1Professor, Dept. of Rehabilitation Sports, Bucheon University, 25 Sinheung-ro 56beon-gil Wonmi-gu, Buecheon-si Gyeonggi-do, 14632, Republic of Korea.
2Professor, Dept. of Beauty and Health, Jungwon University, 85 Munmu-ro, Goesan-eup, Goesan-gun Chungbuk, 367-700, Republic of Korea
*Corresponding Author E-mail: taehab@hanmail.net, jhkim4170@hanmail.net
ABSTRACT:
Background/Objectives: The purpose of this study was to investigate the effects of the Mckenzie exercise program on the relief of back pain and physical fitness. The subjects of this study were middle - aged women living in Seoul, Korea. Methods/Statistical analysis: The control group was able to maintain normal life without participating in the exercise program as the comparison group of experimental group. The experimental group performed the McKenzie exercise for 4 weeks for 50 minutes, including the warm up and the cool down. PASW 18.0 Statistical programs were used to present the descriptive statistics of the measurement variables. Comparisons of the two groups were analyzed by 2-way RGRM ANOVA. The significance level was set to be .05. Findings: There was a significant interaction effect between the two groups before and after the exercise program. This suggests that the McKenzie exercise program is effective in reducing pain(p<.05). There was a significant interaction effect between the two groups before and after the exercise program. This suggests that the McKenzie exercise program is effective in reducing pain (p<.05). Improvements/Applications: This study confirmed that Mckenzie exercise was effective in relieving back pain in middle - aged women with back pain. In the follow up study, it is necessary to examine the various effects of the Mckenzie exercise and to compare the results of the back pain relief program and the physical fitness program.
KEYWORDS: Mckenzie Exercise, Pain, Grip Strength, Back Muscle Strength, Flexibility.
1. INTRODUCTION:
Recently, there are increasing the number of female who are suffering from musculoskeletal system disorders, and low back pain has the biggest proportion among the disorders. Especially, more women suffer from it than men do2, and about 80-90% of the whole popularity suffers from lumbago at least for one time. Normally, acute low back pain may be cured in 10 to 12 weeks with conservative remedy, but 60-75% of the people who recovered from acute low back pain relapse into it, and to 7-10% of the patients, the pain proceeds to chronic low back pain3.
Among the patients, women over their middle age were the biggest proportion which suffered from low back pain. The frequency of feeling back pain was over 60% in the group of women from late thirties to late sixties, and 35% of them replied that they now have pain in their lower back4.
Women in their middle age suffers from low back pain due to the muscular weakness which happens because of the pregnancy and delivery, and the body fat increases due to excessive calory intake, changes in metabolism of internal secretion, low rate of workout, and psychological factors5.
Furthermore, women in their middle age shows the characteristics of transition period, since their physical activity decreases, muscular function decreases, internal secretion becomes off-balanced, and osteoporosis occurs6.
Patients of chronic low back pain were treated with conservative methods such as acupuncture, drug treatment, and physical therapy. However, since conservative methods cannot fully cure and treat chronic back pain, exercise cure has recently added to the treatments of back pain. Regular exercise strengthens muscles, bones, and tendons, and provides nutrition to joints and cartilages. It ultimately develops physical intelligence, which cures the back pain7, and is well known as an effective therapy which decreases pain and improves the condition of disorder8.
Reinforcing muscular strength of the back is actively held to cure the low back pain, and one of the most well-known treatment is 'Mckenzie exercise'.
Cure treatement based on Mckenzie exercise is higly focused on repetitive workout, which includes self-treatment workout, motion exercise, manipulation, and patient education. It does affect the patients to work again and develop their physical capacity9. It as well prevents the recurrence of pain, and ultimately decreases the stress which patients may get10.
In cases of women in their middle age, who have high possibility to suffer from back pains due to less exercise and less participation in exterior activities, exercise program which is designed to increase back muscle strength and flexibility is needed11. Furthermore, Mckenzie exercise is a helpful method to self-correcting postures12.
Mckenzie exercise is now well known as a representative therapy to cure musculoskeletal problems, and is frequently used in clinical demonstrations. Therefore, targeting middle aged women who haveobesity and experiences chronic low back pain, Mckenzie exercise will be conducted to provide basic information about back pain patients-oriented-exercise program, by comparing and analyzing changes of physical strength and back pain of the participants.
The purpose of this study was to investigate the effects of the McKenzie exercise program on the relief of back pain and physical fitness. The subjects of this study were middle - aged women living in Seoul, Korea. The subjects of this study were middle - aged women with over 25% obesity and complaining back pain. Subjects were divided into experimental group (EG) and control group (CG). The subjects of the study are shown in.
The CG was able to maintain normal life without participating in the exercise program as the comparison group of EG. The EG performed the McKenzie exercise for 4 weeks for 50 minutes, including the warm up and the cool down.
The McKenzie exercise is a representative exercise for strengthening the muscles of the lumbar spine. This reduces the load on the lumbar spine and the pressure on the intervertebral discs, and relaxes the tension of the lumbar nerve roots.
The McKenzie exercise was limited to five things: maintaining a prone position, lowering a waist in a prone position, lowering a waist in a prone position, lowering a waist in a right posture, and bending a waist in a lying position. (Table 2)
Pain scores were assessed by Oswestry disability index. Physical fitness was assessed by grip strength (TKK-5401, Japan), back muscle strength (TKK-5492, Japan), and flexibility (DW-704, Japan).
Table1: Physical Characteristic of Subjects (M±SD)
|
Group |
N |
Age (yr) |
Height (cm) |
Weight (kg) |
Fat (%) |
|
EG |
10 |
46.42±3.25 |
162.85±3.20 |
63.44±5.47 |
29.23±3.58 |
|
CG |
10 |
45.67±2.36 |
161.20±3.94 |
62.55±4.80 |
29.90±4.05 |
Table 2: Mckenzie Exercise Program
|
Division |
Intensity |
Warm up/ Cool down |
Main exercise |
|
periods(4week) |
Perform without pain |
Whole body stretching /treadmill walking (20min) |
prone position, lowering a waist in a prone position, lowering a waist in a prone position, lowering a waist in a right posture, bending a waist in a lying position(30min) |
PASW 18.0 Statistical programs were used to present the descriptive statistics of the measurement variables. Comparisons of the two groups were analyzed by 2-way RGRM ANOVA. The significance level was set to be .05.
There was a significant interaction effect (F=1059.067, p=.001) between the two groups before and after the exercise program. This suggests that the McKenzie exercise program is effective in reducing pain (p<.05). (Table 3) (Table 4).
Table 3: Back pain descriptive analysis
|
factor |
group |
Pre-test |
Post-test |
|
Back pain |
EG |
6.50±1.42 |
1.53±.95 |
|
CG |
6.32±1.56 |
6.33±1.44 |
Table 4: Back pain 2-way RGRM ANOVA
|
factor |
SS |
df |
MS |
F |
p |
|
Group |
53.338 |
1 |
53.338 |
14.603 |
.001 |
|
Error |
65.744 |
18 |
3.652 |
|
|
|
Period |
61.430 |
1 |
61.430 |
1050.573 |
.001 |
|
Group*Period |
61.926 |
1 |
61.926 |
1059.067 |
.001 |
|
Error |
1.053 |
18 |
.058 |
|
|
There was a significant interaction effect between the two groups before and after the exercise program in the grip strength (F=6.094, p=.024), back muscle strength (F=98.878, p=.001). Flexibility (F=167.894, p=.001) also has a statistical effect on the McKenzie exercise program(p<.05). <Table 5> <Table 6> <Table 7> <Table 8>.
Table 5: Physical fitness descriptive analysis
|
factor |
group |
Pre-test |
Post-test |
|
Grip strength (kg) |
EG |
26.25±7.34 |
28.10±5.67 |
|
CG |
25.32±4.17 |
25.60±5.30 |
|
|
Back muscle strength (kg) |
EG |
60.95±12.79 |
65.77±11.43 |
|
CG |
59.48±11.94 |
58.91±13.01 |
|
|
Flexibility (cm) |
EG |
10.24±3.07 |
16.81±4.35 |
|
CG |
9.66±4.70 |
10.08±5.49 |
Table 6: Grip strength 2-way RGRM ANOVA
|
factor |
SS |
df |
MS |
F |
p |
|
Group |
29.258 |
1 |
29.258 |
.452 |
.510 |
|
Error |
1165.833 |
18 |
64.769 |
|
|
|
Period |
11.225 |
1 |
11.225 |
11.031 |
.004 |
|
Group*Period |
6.202 |
1 |
6.202 |
6.094 |
.024 |
|
Error |
18.317 |
18 |
1.018 |
|
|
Table 7: Back muscle strength 2-way RGRM ANOVA
|
factor |
SS |
df |
MS |
F |
p |
|
Group |
173.472 |
1 |
173.472 |
.572 |
.459 |
|
Error |
5460.571 |
18 |
303.365 |
|
|
|
Period |
45.199 |
1 |
45.199 |
61.946 |
.001 |
|
Group *Period |
72.146 |
1 |
72.146 |
98.878 |
.001 |
|
Error |
13.134 |
18 |
.730 |
|
|
Table 8: Flexibility 2-way RGRM ANOVA
|
factor |
SS |
df |
MS |
F |
p |
|
Group |
133.043 |
1 |
133.044 |
3.323 |
.085 |
|
Error |
720.611 |
18 |
40.034 |
|
|
|
Period |
122.255 |
1 |
122.255 |
213.382 |
.001 |
|
Group *Period |
96.193 |
1 |
96.193 |
167.894 |
.001 |
|
Error |
10.313 |
18 |
.573 |
|
|
4. DISCUSSION:
This study is designed to observe the changes in physical strength and level of back pain of the participants. The participants are middle aged women who have obesity and low back pain, and the exercise program that the participants will go through is designed for 4 weeks, 4 times a week for 50 minutes each, applying Mckenzie exercise.
When low back pain once occurs, it is hard to fully recover and the recurrence is also frequent. Therefore, prevention is crucial; and there are various curing methods suggested and are being held to prevent relapse of back pain. One of the representative exercise is Mckenzie exercise.
Mckenzie exercise is an important approaching method which develops the soma function of the chronic back pain patients. It has guaranteed its effect by using several factors an including the working range of joints and back, relation with gravity and body weight, and methods without using coxa13.
Previous studies conducting Mckenzie exercise shows results as following. First, from the research of Kwon, Lee, and Park14, they conducted exercise program for 8 weeks, 4 times a week, and found out that it has positively affected chronic back pain patients to alleviate pain, improve physical strength and flexibility. Song and Kim15 conducted program for 16 weeks and four times a week, targeting male and female who were suffering from back pain; and Mckenzie exercise has increased flexibility and muscular endurance. Lee ,Jung, and Eo16 designed a program targeting back pain patients who are overweight; and conducted program for 12 weeks, and three times a week. It has relieved pain. Lastly, the study of Lee17 has also found out that Mckenzie exercise has actually alleviated pain when it is conducted three times a week, for 12 weeks targeting obesed participants.
Lack of flexibility declines the elasticity and movement of the spine, and when it happens with low muscular strength, it becomes a dangerous factor that may cause back pain. Soft tissues in our body are designed maintain the average range of movements. Therefore, when we maintains a certain position for a while, tissues get used to the position, expands its tissues with stretching, and finally enables to expand the movement range of joints18.
In this study, Mckenzie exercise, targeting middle aged women with back pain and obesity, was conducted for 4 weeks, and was able to show that the exercise has improved physical strength and relieved low back pain. This result corresponded with the study result which concluded that muscular workouts positively influences the capacities of back and pain level of chronic back pain19. Mckenzie exercise shows the passive aspect of spinal manipulation, posture of patients, and power which develops the physical strength; therefore it stabilizes facet joints to decrease pain, infection and edema level20. Additionally, activation of strong muscles due to the Mckenzie exercise have induced the contraction of ventral muscles, improved lumbar strength, and alleviated low back pain by stabilizing the back.
As the back pain becomes chronic, the movement range of joints and back gets limited, and it can potentially bring decrease of flexibility, endurance, and soma muscular strength21. Therefore, it is recommended to provide Mckenzie exercise program to middle aged women who suffers from back pain and obesity to further improve the stabilization of the back and lower the pain level at the same time.
In conclusion, Mckenzie exercise was defined as a workout which can help to develop the physical strength and activity of the middle aged women who suffers from back pain and obesity; and can alleviate the pain of the back as well. However, since the study period is short, it is not enough to generalize the study result; and it is recommended to constantly conduct studies and develop additional Mckenzie exercise programs.
5. CONCLUSION AND SUGGESTIONS:
This study was statistically significant for back pain, grip strength, back muscle strength and flexibility in the 4-week Mackenzie exercise program for middle-aged women with back pain. This confirms that the McKenzie exercise relieves back pain, strengthens surrounding muscles, and increases physical fitness. It is necessary to develop a more effective and effective exercise program through comparative study of various back pain relief exercises and physical strength reinforcement programs in the subsequent study.
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Received on 02.04.2019 Modified on 18.05.2019
Accepted on 27.06.2019 © RJPT All right reserved
Research J. Pharm. and Tech. 2019; 12(11): 5301-5304.
DOI: 10.5958/0974-360X.2019.00918.1