Comparative effects of clinic- and virtual reality-based McKenzie extension therapy in chronic non-specific low-back pain

Abstract

PurposeThe study compared the influence of Clinic-Based McKenzie Therapy (CBMT) and a Virtual Reality Game (VRG) version on pain intensity, back extensor muscles endurance, activity limitation, participation restriction, fear avoidance belief, kinesiophobia, and general health status of patients with chronic non-specific low-back pain.MethodsThis quasi-experimental study involved 46 patients (CBMT: <i>n</i> = 24; VRG: <i>n</i> = 22) with ‘directional preference’ for extension, randomized into CBMT or VRG group. Treatment was applied thrice weekly for 8 weeks. Outcomes were assessed at the end of the 4<sup>th</sup> and 8<sup>th</sup> week. Data analysis employed descriptive and inferential statistics of independent t-test, Mann-Whitney U test, repeated measure ANOVA, Friedman’s ANOVA, and ANCOVA. The significance level was set as α = 0.05.ResultsThere were no significant differences in the treatment outcomes (mean change) across the groups (<i>p</i> > 0.05), except for kinesiophobia, where VRG led to a significantly higher decline in mean rank at week 4 (28.3 vs. 19.1; <i>p</i> = 0.018) and 8 (28.7 vs. 18.7; <i>p</i> = 0.009), and vitality (a general health status item) at week 4 (27.6 vs. 19.8; <i>p</i> = 0.042) and 8 (28.1 vs. 19.3; <i>p</i> = 0.042). ANCOVA showed that significant baseline parameters were not significant predictors of vitality (F = 1.986; <i>p</i> = 0.070) or kinesiophobia (F = 0.866; <i>p</i> = 0.563) outcomes.ConclusionsThe VRG mode of McKenzie therapy is comparable with the clinic-based approach in most outcomes. VRG has a superior effect on kinesiophobia, but may take a higher toll on vitality/energy.