PURPOSE: To evaluate whether patients' treatment preferences, characteristics, or symptomatic response to assessment moderated the effect of the McKenzie method for acute low back pain (LBP). METHODS: This study involved a secondary analysis of a previous RCT on the effect of adding the McKenzie method to the recommended first-line care for patients with acute non-specific LBP. 148 patients were randomized to the First-line Care Group (recommended first-line care alone) or the McKenzie Group (McKenzie method in addition to the first-line care) for a 3-week course of treatment. The primary outcome was pain intensity at 3 weeks. The ability of six patient characteristics to identify those who respond best to McKenzie method was assessed using interaction terms in linear regression models. RESULTS: The six investigated potential effect modifiers for response to the McKenzie method did not predict a more favorable response to this treatment. None of the point estimates for effect modification met our pre-specified criterion of clinical importance of a 1 point greater improvement in pain. For five of the six predictors, the 95% CI did not include our criterion for meaningful clinical improvement. CONCLUSION: We were unable to find any clinically useful effect modifiers for patients with acute LBP receiving the McKenzie method.
AD - Duke University Health System, 3116 N. Duke St, Durham, NC, USA, charles.sheets@duke.edu. AN - 22109566 BT - European Spine Journal C2 - 3389098 DP - NLM ET - 2011/11/24 J2 - LA - eng M1 - 7 N1 - Sheets, CharlesMachado, Luciana A CHancock, MarkMaher, ChrisGermanyEur Spine J. 2012 Jul;21(7):1250-6. Epub 2011 Nov 23. N2 -PURPOSE: To evaluate whether patients' treatment preferences, characteristics, or symptomatic response to assessment moderated the effect of the McKenzie method for acute low back pain (LBP). METHODS: This study involved a secondary analysis of a previous RCT on the effect of adding the McKenzie method to the recommended first-line care for patients with acute non-specific LBP. 148 patients were randomized to the First-line Care Group (recommended first-line care alone) or the McKenzie Group (McKenzie method in addition to the first-line care) for a 3-week course of treatment. The primary outcome was pain intensity at 3 weeks. The ability of six patient characteristics to identify those who respond best to McKenzie method was assessed using interaction terms in linear regression models. RESULTS: The six investigated potential effect modifiers for response to the McKenzie method did not predict a more favorable response to this treatment. None of the point estimates for effect modification met our pre-specified criterion of clinical importance of a 1 point greater improvement in pain. For five of the six predictors, the 95% CI did not include our criterion for meaningful clinical improvement. CONCLUSION: We were unable to find any clinically useful effect modifiers for patients with acute LBP receiving the McKenzie method.
PY - 2012 SN - 1432-0932 (Electronic)0940-6719 (Linking) SP - 1250 EP - 6 ST - T2 - European Spine Journal TI - Can we predict response to the McKenzie method in patients with acute low back pain? A secondary analysis of a randomized controlled trial VL - 21 ER -