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Mckenzie Part A
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Mckenzie Part A - April 20, 2006 4:47:00 AM
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apolipo
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From: Grand Rapids, MI
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Has anyone been to the McKenzie Part A - Lumbar Spine course? We have been receiving more referrals from docs asking for "McKenzie Certified" therapists. The Lumbar spine course is 4 days long. What the heck are they doing for 4 days? We don't want to send someone for that long and for that much $$ if it is not worth it.
mike t
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Re: Mckenzie Part A - April 20, 2006 9:41:00 AM
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TLB
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I highly recommend it! Centralization, mobilization and stabilization is defitely the way to go if trained properly. I thought Mark Miller was a great instructor. Good luck and it's well worth the time and money.
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Todd
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Re: Mckenzie Part A - April 20, 2006 12:14:00 PM
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apolipo
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From: Grand Rapids, MI
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Todd,
Stabilization? What, specifically, are you talking about? Are we talking neuromuscular re-ed, local stabilizer training, Shirley Sahrmann-style stabilization training or something different?
Also, how much do they offer in regards to research supporting the basic premise of the McKenzie approach as well as outcome studies? I did a PubMed search and came up with a few hits regarding outcomes, but no big shining star.
Thanks for your reply.
mike t
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Re: Mckenzie Part A - April 20, 2006 2:59:00 PM
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rwillcott
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I've taken Part A and B and found these courses to be very useful.
Here a couple of studies to look for:
1. Long et al. Does it Matter Which Exercise?: A Randomized Control Trial of Exercise for Low Back Pain. Spine. December 2004, 29 (23):2593-602.
This is an excellent study that demonstrates the importance of determining a "direction of preference". This is a way of subclassifying patients with back pain. Once you determine the classification that the patient fits you treat accordingly.
The study demonstrated that early pain reduction using patient-specific directional exercises significantly decreased the need for medication, while improving all outcome measures (including Roland-Morris Disability Questionnaire RMDQ, patient satisfaction, depression, and activity interference)
2. Aina et al. The Centralization Phenomenon of Spinal Symptoms - A Sytematic Review. Manual Therapy 2004: 134-143.
Hope these help,
Rob
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Re: Mckenzie Part A - April 22, 2006 7:47:00 AM
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RoyCoronado
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I have used Mckenzie in my clinicals and I have seen good outcomes with some of the LBP patients I have seen. I was wondering, are there any research studies on why McKenzie therapy works? I know that McKenzie is proposed to work because of reduction of the disc via extension (NP moves anterior), but has this been proven?
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Roy Coronado SPT, CSCS
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Re: Mckenzie Part A - April 22, 2006 8:32:00 AM
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rwillcott
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I don't think that it's ever been proven that if it's the disc that is being reduced with repeated movements. However, centralization and it's important role in the treatment of LBP has been proven using the McKenzie principles. (Aina et al. Manual Therapy, 2004:134-143.)
What matters is if you can find a direction of preference that centralizes and abolishes symptoms.
I don't think we'll ever know with 100% accuracy if it's the disc, Z joint, SI joint, nerve, hip, index finger, frontal lobe, chi etc. As long as the patient's pain reduces and their function improves we're doing the right thing.
Rob
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Re: Mckenzie Part A - April 22, 2006 9:55:00 AM
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jma
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There are plenty of articles posted from the McKenzie Institute website at:
http://www.mckenziemdt.org/libResearchList.cfm
Its no wonder doctor write them down on their scripts.
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Re: Mckenzie Part A - April 22, 2006 1:17:00 PM
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nari
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Charles
Thanks for posting a balanced view on a topic that is sacred to some PTs; which is never a good way to go.
Nari
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Re: Mckenzie Part A - April 24, 2006 2:41:00 AM
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apolipo
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The schedule was slow on Friday, so I spent some time on PUBMED looking for abstracts regarding McKenzie. The common thread I found was good outcomes for pts. whose pain centralized with movement in a particular direction, not so good outcomes when there was no centralization or partial centralization.
Just to add a twist to the discussion, we should consider some of the research done in the last 15 years "Down Under" by Richardson, Hodges, and Hide regarding local stabilzer function. They have consistently shown poor functioning and timing of the local spinal stabilizers in people with acute and chronic LBP. This dysfunction seems to persist even when symptoms resolve. If a directional preference is found and pain is centralized and then eliminated, is our job completed? I would say no.
mike t
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Re: Mckenzie Part A - April 24, 2006 10:09:00 AM
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PHSPT
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I agree Mike,
After reducing/centralizing and abolishing my pnts (discogenic pnts respond well) I start them on a solid core stab exercise program. especially Trans abd. and E. Spinae.
I have only attended part A, and have found that Mackenzie works well w/ HNPs. I rely on maitlands and osteopathic approach for all other low back conditions, this is what I found to work for me. I feel that Mckenzie has provided an alternate approach to treat back patients,with outstanding results.
I say go for it!
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Re: Mckenzie Part A - April 24, 2006 2:36:00 PM
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rwillcott
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Back to your original question Mike, take a McKenzie course. The next time you have a patient come in with acute back pain and a shift your patient will thank you for it.
In addition, become comfortable with the techniques of Sahrmann, Mulligan, the Australian stabilization work, Childs et al and the Clinical Prediction Rules etc.
Not one technique works for all patients. The more tools in the tool box the better PT you'll be.
Rob
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Re: Mckenzie Part A - April 24, 2006 4:43:00 PM
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inotadots
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I just completed a course this weekend, American Back Pain Center on lumbar spine for training on directional preference. I highly recommend the course. The owner/instructor is highly efficient and organized, and previous top instuctor for McKenzie institute. I had never used the centralization approach to low back pain consistently, and now am eager to start practicing. See the web site for dates and times: [URL=http://www.americanbackpaincenter.com.]www.americanbackpaincenter.com.[/URL] Yes it is four days, but by the time you are done, you will feel confident that a systematic approach will pinpoint the centralizers that will respond to this approach.
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Re: Mckenzie Part A - April 25, 2006 3:58:00 AM
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Shill
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Incidentally, the instructor referred to by inotadots is Angelo Dimaggio, referred to in the previous discussion, linked by Charles Sheets above.
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Steve Hill PT
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Re: Mckenzie Part A - April 27, 2006 3:58:00 AM
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varsha2000
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Are the following true,
1. Mckenzie techs are of value only if 80% of your patient population has LBP?
2. That it is most helpful for only people with herniated discs?
3. One must take the courses in succession without pacing them out. (courses A-D, one each month)
I work in an outpatient ortho clinic and see more than LBP. Am trying to decide if I should take Part A. I would appreciate your opinions.
Thanks.
Varsha
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Re: Mckenzie Part A - April 27, 2006 5:10:00 AM
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TLB
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From: Arizona
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false
false
false
Get to a course
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Todd
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Re: Mckenzie Part A - April 27, 2006 5:52:00 AM
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apolipo
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From: Grand Rapids, MI
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Varsha,
I am of the opinion that using all of your CE dollars for 4-5 McKenzie courses will not give you a broad enough education. It would be better to spread those dollars out to learn more regarding segmental spinal stabilization, movement system impairments, functional biomechanics, current pain science, abnormal neurodynamics, etc.
I'm not trying to say McKenzie has no value, but it seems like putting all your eggs in one basket. Attending all of one type of course does not give you a deep enough knowledge to critically think through difficult pts. McKenzie won't work for everyone, but neither will Shirley Sahrmann's techniques, or Maitland's, or MFR, or MET, or etc., etc., etc.
Just my opinion.
mike t
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Re: Mckenzie Part A - April 27, 2006 9:30:00 AM
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TLB
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From: Arizona
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Mike,
Unless I missed something and that sometimes happens frequently I didn't see it stated anywhere that someone needs to take all 4 courses or spend all their CEU money on McKenzie. Varsha I highly recommend A and B although the new Angelo Dimaggio course sounds interesting.
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Todd
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Re: Mckenzie Part A - April 27, 2006 11:07:00 AM
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PHSPT
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From: Oklahoma
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Varsha,
I feel that attending a part per year, is the optimal way to go. This will accomplish 3 things. 1) Allow you to put the didactic work to practice, practice, practice!!it doesnt matter what tech you learn, you must give yourself ample time to put it to work 2) Will allow you to not to place your entire kids college fund, on mckenzie!! it will give you some financial freedom. The entire process can be quite expensive, 3)Allow you to explore and learn other techniques that i feel are important to enhance your overall knowledge of back pathology.
I feel mckenzie tecniques are highly regarded from an EBM perspective and need to be learned by all therapists wanting that extra edge.
My thoughts
Carlos
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Re: Mckenzie Part A - April 27, 2006 4:23:00 PM
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varsha2000
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Thanks a lot for all your advice. Really appreciate it.
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