McKenzie Method Research Articles

Effect of the Mckenzie's Method of Mechanical Diagnosis and Therapy and Pain Releasing Phenomenon in Subjects with Dequervain's Tenosynovitis

Effect of the Mckenzie's Method of Mechanical Diagnosis and Therapy and Pain Releasing Phenomenon in Subjects with Dequervain's Tenosynovitis

Repetitive Mckenzie Spinal Extension Exercises on Cardiovascular Responses in Class I Obese Subjects

Background: Obese population is dramatically increasing worldwide. There is a strong association between obesity and low back pain. The 1-month prevalence of low back pain ranges from 30% to 40% in the general population. McKenzie method is commonly used in the diagnosis and management of patients with back pain. The objective of the study is to examine the cardiovascular responses of two common exercises namely, extension in lying (EIL) and extension in standing (EIS) used in the McKenzie system with different repetitions among class I obese subjects.Method: 50 class I obese subjects (25 males and 25 females) were randomly selected within the age range of 20-40 years. Baseline measures of resting heart rate (HR), blood pressure (BP) and rate pressure product (RPP) were taken before and after exercises. Multiple comparisons were done to analyze the significance within groups. One-way analysis of variance for repeated measures was used to compare the dependent values obtained at rest and after 10, 15 and 20 repetitions. Independent “t” test was used to determine the significance between groups.Results: No significant differences (p>0.05) were found in SBP and DBP after 10 repetitions in group 1 and among HR and SBP after 10 and 15 repetitions in group 2. There was a significant difference (p<0.05) in RPP after 15 and 20 repetitions within and between the groups.Conclusion: Increased repetitions of spinal extension exercises in prone lying bring more cardiovascular stress when compared to the same performed in the standing position among class 1 obese subjects.

慢性の非特異的腰痛患者に対するMcKenzie 法とストレッチング,その両方の介入効果─単盲検準ランダム化比較試験─

慢性の非特異的腰痛患者に対するMcKenzie 法とストレッチング,その両方の介入効果─単盲検準ランダム化比較試験─

Efektivitas Program Back School Dan Teknik Mckenzie Pada Pasien Nyeri Punggung Bawah

Abstract : Back School Program, Mckenzie Techniques, Pain, Vas, Patients With Low Back Pain. On the other hand needed McKenzie method for relaxation to the muscles of the back due to spasm, so that the pain can be reduced. To prove the effectiveness of the program back school and McKenzie techniques in reducing lower back pain. Types of Research: experimental study. Two group pre test-post test design. Place and Time Research in Unit physiotherapy Hospital Dr Moewardi Surakarta from January to June 2015. Sample: lower back pain patients who met the study criteria. Research variables: independent variable is a back school program and McKenzie techniques, while the dependent variable was pain. The research data in the form of pain measured by VAS. Data obtained include scale ratio. Statistical Analysis: The subjects in one group <30 people, then analyzed with nonparametric tests. Homogeneity of data were tested with the Mann-Whitney test was obtained p = 0.030 (P <0.05) indicates the data are not homogeneous. Wilcoxon test group I obtained p = 0.000 (p <0.05) showed no difference effect of back school programs to decrease lower back pain. Wilcoxon test group II obtained p = 0.000 (p <0.05) showed no difference effect of McKenzie technique to decrease lower back pain. Mann-Whitney test after treatment was obtained p = 0.006 (p <0.05) showed no difference in effectiveness between the back school program with McKenzie techniques in reducing lower back pain. Results of the mean difference in pain reduction anatara back school program with the technique gained 9.71 higher McKenzie Techniques. McKenzie Technique is more effective than a back school program to reduce lower back pain.

A Randomized Controlled Trial Comparing the McKenzie Method to Motor Control Exercises in People With Chronic Low Back Pain and a Directional Preference.

Study Design Randomized clinical trial. Background Motor control exercises are believed to improve coordination of the trunk muscles. It is unclear whether increases in trunk muscle thickness can be facilitated by approaches such as the McKenzie method. Furthermore, it is unclear which approach may have superior clinical outcomes. Objectives The primary aim was to compare the effects of the McKenzie method and motor control exercises on trunk muscle recruitment in people with chronic low back pain classified with a directional preference. The secondary aim was to conduct a between-group comparison of outcomes for pain, function, and global perceived effect. Methods Seventy people with chronic low back pain who demonstrated a directional preference using the McKenzie assessment were randomized to receive 12 treatments over 8 weeks with the McKenzie method or with motor control approaches. All outcomes were collected at baseline and at 8-week follow-up by blinded assessors. Results No significant between-group difference was found for trunk muscle thickness of the transversus abdominis (-5.8%; 95% confidence interval [CI]: -15.2%, 3.7%), obliquus internus (-0.7%; 95% CI: -6.6%, 5.2%), and obliquus externus (1.2%; 95% CI: -4.3%, 6.8%). Perceived recovery was slightly superior in the McKenzie group (-0.8; 95% CI: -1.5, -0.1) on a -5 to +5 scale. No significant between-group differences were found for pain or function (P = .99 and P = .26, respectively). Conclusion We found no significant effect of treatment group for trunk muscle thickness. Participants reported a slightly greater sense of perceived recovery with the McKenzie method than with the motor control approach. Level of Evidence Therapy, level 1b-. Registered September 7, 2011 at www.anzctr.org.au (ACTRN12611000971932). J Orthop Sports Phys Ther 2016;46(7):514-522. Epub 12 May 2016. doi:10.2519/jospt.2016.6379.

Efektivitas Program Back School Dan Teknik Mckenzie Pada Pasien Nyeri Punggung Bawah

Abstract: Back School Program, Mckenzie Techniques, Pain, Vas, Patients With Low Back Pain. Low back pain is a problem that affects about 60-80% of the population in his lifetime. This pain is often triggered behavior ergonomics so that the necessary education in school programs to lower back pain. On the other hand needed McKenzie method for relaxation to the muscles of the back due to spasm, so that the pain can be reduced. Objective: To prove the effectiveness of the program back school and McKenzie techniques in reducing lower back pain. Types of Research: an experimental study. The study design: two group pre-test-post-test design. Statistical Analysis: The subjects in one group <30 people, then analyzed with nonparametric tests. Homogeneity of data was tested with the Mann-Whitney test was obtained p = 0.030 (P <0.05) indicates the data are not homogeneous. Wilcoxon test group I obtained p = 0.000 (p <0.05) showed no differential effect of back school programs to decrease lower back pain. Wilcoxon test group II obtained p = 0.000 (p <0.05) showed no differential effect of McKenzie technique to decrease lower back pain. Mann-Whitney test after treatment was obtained p = 0.006 (p <0.05) showed no difference in effectiveness between the back school program with McKenzie techniques in reducing lower back pain. Results of the mean difference in pain reduction anatara back school program with the technique gained 9.71 higher McKenzie McKenzie techniques. Conclusion: McKenzie technique is more effective than a back school program to reduce lower back pain

Lumbar lateral shift in a patient with interspinous device implantation: a case report

Background:Lumbar lateral shift (LLS) is a common clinical observation but has rarely been described in a patient with a history of lumbar surgery. The purpose of the current case report was to describe the use of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) in the multi-modal treatment of a patient with an LLS and a history of multiple surgical procedures in the lumbar spine, including interspinous process device (IPD) implantation.Case description:A 72-year-old female with chronic low back pain (LBP) and a surgical history in the lumbar spine was referred to physical therapy for radiating leg pain and presented with a right LLS. Her chief complaints included sitting for long periods, vacuuming and ascending stairs into her home.Outcomes:The patient was treated during eight visits over 30 days. Treatment interventions included manual shift correction, self-correction and management, joint mobilisation below the level of IPD implantation ,neurophysiology education, and development of a home exercise programme. At discharge, her leg pain was resolved and all goals had been met. The patient reported maintenance of gains at 6-month follow-up.Discussion:Utilisation of the MDT approach, including LLS correction, produced positive outcomes in a complex patient with previous IPD implantation. Future research should investigate treatment and outcomes after invasive spinal procedures in similar patient populations to better inform clinical management.Level of evidence:4.

Effect of Mckenzie Method with tens on Lumbar Radiculopathy-A Randomized Controlled Trial

Background: Lumbar radiculopathy is a disease of the spinal nerve root generally accompanied by radicular pain in dermatomal distribution and/or neurologic symptoms. The previous studies were focusing on finding the disability and pain caused due to Lumbar Radiculopathy. This study is focusing on the disability, pain, range of motion of the spine and SLR. The objective of the study is to evaluate the effectiveness of Mckenzie method with TENS on reducing symptoms and disability of Lumbar radiculopathy.Methods: In the present prospective study patients with Lumbar radicular pain due to disc herniation or prolapse at level L4, L5 & S1 were randomized into two groups – Group A and Group B. the study included 40 patients, with 20 in each group. The selection criteria was based on the following - with age group 22-55years, both sexes – male and female, with radicular pain in L4, L5 & S1 dermatomes, disabling leg pain for 6-12 weeks duration, evidence of disc herniation confirmed on MR imaging. The radicular pain was measured using the SLR test, pain was measured using the VAS scale of 0 – 100, disability was measured using the MODI and Lumbar Spine ROM was measured using the MMST. Group-A were treated with McKenzie methods with TENS and Group-B were treated with general exercisewith TENS.Results: This study showed that there was a significant reduction of pain on the VAS, improvement in SLR, lumbar spine range of motion using MMST and disability using MODI for both the groups. The statistical analysis found that experimental group showed earlier control of all the outcome measures when compared to controlled group at the end of the 6th week.Conclusion: After 6 weeks of Mckenzie method with TENS intervention for 30 minutes for 5 days in week the statistical analysis concluded that the experimental group had significantly faster rates of reducing the symptoms of lumbar radiculopathy and reducing the disability due to lumbar radiculopathy.

Effectiveness of Mc Kenzie Exercises in Reducing Neck and Back Pain among Madrassa Students

Background: In this advanced era, neck and back pain has become a common musculoskeletal problem. These symp toms have a high prevalence in the community and now they are affecting even our adolescents leaving a major impact on youth’s functional and educational activities. Nevertheless, the burden of these musculoskeletal pains, which relates not only to its prevalence but also to increase in physiological and psychological stress among them, distressing their creativity. Madrassa students have a daily exposure to neck and back pain due to poor posture. The McKenzie method is a popular treatment for back and neck pain among physical therapists. So, the intention of this study is to test the effec tiveness of McKenzie exercises in neck and back pain, because hardly any data is available on McKenzie technique and its outcome in Pakistan. The objective of the study is to determine the effectiveness of McKenzie exercises in reducing neck and back pain among madrassa students. Methods: The students were recruited from Madrassa Darul Akram (Baldia town) and Jamia Ashraf-ul-madrassa (Gul shan-e-Iqbal) Karachi. One sixty three students aged between 12–18 years of both genders who were fulfilling the inclusion criteria were selected from Madrassa Darul Akram (Baldia town) and Jamia Ashraf-ul-madrassa (Gulshane-Iqbal). The participants received McKenzie exercises programs intervention for three consecutive weeks. Outcome Measure: Neck Disability Index (NDI), Modified Oswestry Low Back Pain Disability Index (ODI) and Numeric Pain Rating Scale (NPRS) Results: The present study showed significant results in all three scales in both genders (p<0.001).Among sections, the Hafiz students revealed greater score in all 3 scales before treatment as compared to ‘Alim/Alima’ and ‘Nazra’ students and after treatment showed significant results in all 3 domains (p<0.001). Conclusion: Findings of this study revealed that madrassa students were more prone to develop neck and back pain. This might be either because of strict enforcement by teachers or usual poor sitting habit. Most of the time, it is difficult for students to come regularly for therapy sessions. It is concluded that McKenzie exercises had significantly reduced the neck and back pain among madrassa students.

McKenzie method for low back pain

ABSTRACT BACKGROUND AND OBJECTIVES: Low back pain is a disorder affecting people of all ages, being among major diseases leading individuals to look for health professionals' help. Clinicians agree that back pain is a heterogeneous condition, however there is no uniformity in the choice of most effective methods to manage pain. This study aimed at evaluating the contribution of the McKenzie method to manage low back pain, in addition to checking whether there is comparison of McKenzie with other treatment modalities. CONTENTS: Health Virtual Library and Pubmed portals were queried from November 2013 to March 2014. All studies were analyzed according to quality criteria established by the PEDro scale, in addition to inclusion and exclusion criteria established by the authors. Of 353 studies found, just six were considered eligible. McKenzie method compared to other therapeutic approaches was effective in functional performance and dysfunction indices, however there has been discrepancy of results due to heterogeneous samples of different clinical trials. CONCLUSION: Although having contributed to manage low back pain patients, McKenzie method requires further studies to validate the technique in specific patient groups.

Analysis of Effects of and Factors Related to Exercise Therapy in Patients with Cervical Degenerative Disease Using McKenzie Method

Analysis of Effects of and Factors Related to Exercise Therapy in Patients with Cervical Degenerative Disease Using McKenzie Method

Physical therapists’ level of McKenzie education, functional outcomes, and utilization in patients with low back pain

Study Design Longitudinal, prospective, observational cohort. Objective To examine associations between McKenzie training, functional status (FS) at discharge, and number of physical therapy visits (utilization) in patients receiving physical therapy for low back pain. Background The McKenzie method is commonly used in treating patients with low back pain. Methods A McKenzie postgraduate educational program was initiated in a large outpatient physical therapy service. Functional status data were collected at intake and at discharge. Separate hierarchical linear mixed models were used to examine associations between physical therapists' McKenzie training level (none; Parts A, B, C, and D; and credentialed), FS score at discharge, and utilization, controlling for patient risk factors. Results The final data set included 20 882 patients (mean ± SD age, 51 ± 16 years; 57% women) who completed FS surveys at both admission and discharge. Patients treated by physical therapists with any McKenzie training had bet...

골반부와 관련된 국내임상연구동향 고찰 -골반부의 변위를 중심으로-

Objectives The purpose of this review was to analyze the research trends in clinical research related to pelvic malposition published in Korean medicine journals. Methods We searched articles in Korean databases (OASIS, NDSL, RISS, and KTKP), and sorted the articles by publishing date, pelvic malposition type, field of study, and measurement index. Results 1. 25 original articles and 9 case report articles were reviewed. 2. In recent years, this topic has been studied more frequently, with an increasing number of original articles published. 3. 16 articles analyzed pelvic malposition type. And half of the articles focused on ilium. 4. The original articles have figured out the correlation between pelvic malposition measurement indices and other measurement indices or diseases. 5. Treatment tools, such as chuna therapy, the mckenzie method, devices for correcting malposition, acupuncture were used in the case report articles. 6. 29 measurement indices, such as Ferguson`s angle, Ilium shadow measurement, and Iliac height difference were used. Conclusions According to the literature, pelvic malposition is related to other diseases and measurement indices, and manual medicine on pelvic malposition can be effective. However, due to the lack of sufficient empirical evidence from medical articles to support this, further clinical research should be conducted.

Predicting a clinically important outcome in patients with low back pain following McKenzie therapy or spinal manipulation: a stratified analysis in a randomized controlled trial.

BackgroundReports vary considerably concerning characteristics of patients who will respond to mobilizing exercises or manipulation. The objective of this prospective cohort study was to identify characteristics of patients with a changeable lumbar condition, i.e. presenting with centralization or peripheralization, that were likely to benefit the most from either the McKenzie method or spinal manipulation.Methods350 patients with chronic low back pain were randomized to either the McKenzie method or manipulation. The possible effect modifiers were age, severity of leg pain, pain-distribution, nerve root involvement, duration of symptoms, and centralization of symptoms. The primary outcome was the number of patients reporting success at two months follow-up. The values of the dichotomized predictors were tested according to the prespecified analysis plan.ResultsNo predictors were found to produce a statistically significant interaction effect. The McKenzie method was superior to manipulation across all subgroups, thus the probability of success was consistently in favor of this treatment independent of predictor observed. When the two strongest predictors, nerve root involvement and peripheralization, were combined, the chance of success was relative risk 10.5 (95% CI 0.71-155.43) for the McKenzie method and 1.23 (95% CI 1.03-1.46) for manipulation (P = 0.11 for interaction effect).ConclusionsWe did not find any baseline variables which were statistically significant effect modifiers in predicting different response to either McKenzie treatment or spinal manipulation when compared to each other. However, we did identify nerve root involvement and peripheralization to produce differences in response to McKenzie treatment compared to manipulation that appear to be clinically important. These findings need testing in larger studies.Trial registrationClinicaltrials.gov: NCT00939107Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0526-1) contains supplementary material, which is available to authorized users.

Clinical picture dynamics in lumboischiadic syndrome, with and without radicular irritation, using McKenzie concept principles

AimComparison of intensity, sensitive and affective components, disability, motion range of the m. erector spinae muscle activity during both dynamic and static activities at the sagittal level regarding the most frequent diagnoses, within the framework of classification by the McKenzie method. Patient sampleThe research sample consisted of 31 patients by the MRI-diagnosed discopathy, who were divided into two groups. Both of these groups were treated using the McKenzie method. Group 1 involved the central symmetrical posterior derangement (n=15). Group 2 involved the unilateral asymmetrical derangement, with emanation of pain into the lower limb (n=16). MethodsFor the measurement of the intensity and character of pain, the McGill Pain Questionnaire – its short form (SF MPQ) was used. The pain intensity was evaluated by the visual analogue scale (VAS). The disability was evaluated by the Roland Morris Questionnaire (RMQ). The m. erector spinae muscle activation measurement from L4 area paravertebrally was conducted by the surface EMG in μV. The range of motion was measured by a goniometry. ResultsGroup 1: activation of the m. erector spinae: no significant lateral differences were found and activation of the m. erector spinae was declining symmetrically. Group 2: in this group, there was the occurrence of lateral differences recorded on the right side versus the left side. On the painful side, the activation changes manifested themselves most markedly with their increase during the flexion in the upright posture and with their decline occurring during extension while standing, which presented the therapeutic principle. In the assessment of intensity and perception of pain, disability and motion ranges, no significant differences were found. One month and three months after the treatment there was a significant decrease in pain in both of the groups (p<0.05). ConclusionDuring the treatment, we have managed to record changes in intensity, pain localization and motion ranges in the monitored groups, which was in compliance with the clinical picture syndromes according to McKenzie.

Can standing back extension exercise improve or prevent low back pain in Japanese care workers?

Background:We suggested a standing back extension exercise ‘One Stretch’ based on the McKenzie method, to examine the ability to improve or prevent low back pain (LBP) in Japanese care workers.Methods:We conducted a single-center, non-randomized, controlled study in Japan. Care workers in an intervention group received an exercise manual and a 30-minute seminar on LBP and were encouraged with a group approach, while care workers in a control group were given only the manual. All care workers answered questionnaires at the baseline and end of a 1-year study period. The subjective improvement of LBP and compliance with the exercise were evaluated.Results:In all, 64 workers in the intervention group and 72 in the control group participated in this study. More care workers in the intervention group exercised regularly and improved or prevented LBP than in the control group (P = 0·003 and P<0·0001, respectively). In the intervention group, none had a first medical consultation or were absent from disability for LBP by the end of the study period.Conclusion:The exercise ‘One Stretch’ would be effective to improve or prevent LBP in care workers. Our group approach would lead to better compliance with the exercise.

Impact of McKenzie Method Therapy Enriched by Muscular Energy Techniques on Subjective and Objective Parameters Related to Spine Function in Patients with Chronic Low Back Pain.

BackgroundThe high incidence and inconsistencies in diagnostic and therapeutic process of low back pain (LBP) stimulate the continuing search for more efficient treatment modalities. Integration of the information obtained with various therapeutic methods and a holistic approach to the patient seem to be associated with positive outcomes.The aim of this study was to analyze the efficacy of combined treatment with McKenzie method and Muscle Energy Technique (MET), and to compare it with the outcomes of treatment with McKenzie method or standard physiotherapy in specific chronic lumbar pain.Material/MethodsThe study included 60 men and women with LBP (mean age 44 years). The patients were randomly assigned to 1 of 3 therapeutic groups, which were further treated with: 1) McKenzie method and MET, 2) McKenzie method alone, or 3) standard physiotherapy for 10 days. The extent of spinal movements (electrogoniometry), level of experienced pain (Visual Analogue Scale and Revised Oswestry Pain Questionnaire), and structure of the spinal discs (MRI) were examined prior to the intervention, immediately thereafter, and 3 months after the intervention.ResultsMcKenzie method enriched with MET had the best therapeutic outcomes. The mobility of cervical, thoracic, and lumbar spine normalized at levels corresponding to 87.1%, 66.7%, and 95% of respective average normative values. Implementation of McKenzie method, both alone and combined with MET, was associated with a significant decrease in Oswestry Disability Index, significant alleviation of pain (VAS), and significantly reduced size of spinal disc herniation.ConclusionsThe combined method can be effectively used in the treatment of chronic LBP.

Physical therapists' level of McKenzie education, functional outcomes, and utilization in patients with low back pain.

Longitudinal, prospective, observational cohort. To examine associations between McKenzie training, functional status (FS) at discharge, and number of physical therapy visits (utilization) in patients receiving physical therapy for low back pain. The McKenzie method is commonly used in treating patients with low back pain. A McKenzie postgraduate educational program was initiated in a large outpatient physical therapy service. Functional status data were collected at intake and at discharge. Separate hierarchical linear mixed models were used to examine associations between physical therapists' McKenzie training level (none; Parts A, B, C, and D; and credentialed), FS score at discharge, and utilization, controlling for patient risk factors. The final data set included 20 882 patients (mean ± SD age, 51 ± 16 years; 57% women) who completed FS surveys at both admission and discharge. Patients treated by physical therapists with any McKenzie training had better outcomes (additional 0.7 to 1.3 FS points; P<.05 to <.001) and fewer visits (0.6 to 0.9, P<.001) compared to patients treated by physical therapists with no training. For patients treated by therapists with no versus some McKenzie education, 65% versus 70% achieved at least the minimal clinically important improvement, respectively. There were no significant differences in outcomes or utilization by level of McKenzie training. There was a slightly greater improvement of 0.7 to 1.3 points in FS at discharge in patients receiving physical therapy for low back pain by physical therapists who underwent McKenzie training. This difference was clinically important for an additional 5% of patients who achieved the minimal clinically important improvement when treated by therapists with some McKenzie training. Reduction in physical therapy utilization was 0.6 to 0.9 visits, with the fewest visits utilized by patients of physical therapists at the McKenzie Part D and credentialed levels. Together, these findings suggest improved cost-effectiveness at advanced McKenzie training levels. Ways to improve ongoing education and patient outcomes were proposed.

Efficacy of the McKenzie method in patients with chronic nonspecific low back pain: a protocol of randomized placebo-controlled trial.

The McKenzie method is widely used as an active intervention in the treatment of patients with nonspecific low back pain. Although the McKenzie method has been compared with several other interventions, it is not yet known whether this method is superior to placebo in patients with chronic low back pain. The purpose of this trial is to assess the efficacy of the McKenzie method in patients with chronic nonspecific low back pain. An assessor-blinded, 2-arm, randomized placebo-controlled trial will be conducted. This study will be conducted in physical therapy clinics in São Paulo, Brazil. The participants will be 148 patients seeking care for chronic nonspecific low back pain. Participants will be randomly allocated to 1 of 2 treatment groups: (1) McKenzie method or (2) placebo therapy (detuned ultrasound and shortwave therapy). Each group will receive 10 sessions of 30 minutes each (2 sessions per week over 5 weeks). The clinical outcomes will be obtained at the completion of treatment (5 weeks) and at 3, 6, and 12 months after randomization. The primary outcomes will be pain intensity (measured with the Pain Numerical Rating Scale) and disability (measured with the Roland-Morris Disability Questionnaire) at the completion of treatment. The secondary outcomes will be pain intensity; disability and function; kinesiophobia and global perceived effect at 3, 6, and 12 months after randomization; and kinesiophobia and global perceived effect at completion of treatment. The data will be collected by a blinded assessor. Therapists will not be blinded. This will be the first trial to compare the McKenzie method with placebo therapy in patients with chronic nonspecific low back pain. The results of this study will contribute to better management of this population.

New method for assessing hand disinfection shows that pre-operative alcohol/chlorhexidine rub is as effective as a traditional surgical scrub

Several studies have shown that rubbing hands with an alcohol/chlorhexidine solution provides equivalent microbial decontamination to a conventional surgical scrub using aqueous chlorhexidine. However, the authors believe that these studies have methodological flaws that limit their applicability to the operating theatre environment. As such, a method was developed to compare products in an everyday operating theatre environment using working operating theatre personnel. To determine whether or not an alcohol/chlorhexidine rub is as efficacious as a traditional surgical scrub using a novel method. Bacterial counts at baseline were collected from 20 anaesthetists using the glove juice method. Subsequently, with sequential exchange of sterile gloves, one hand underwent a 3-min scrub using 4% aqueous chlorhexidine, and the other hand underwent a 60-s rub with a 70% isopropyl alcohol/0.5% chlorhexidine solution. The residual bacterial count was collected for each hand after 30 min using the glove juice method. These counts were converted to log10 values to compare the baseline counts of right and left hands, and efficacy between the treatment groups. Mean [± standard deviation (SD)] bacterial counts at baseline were (log10) 4.42 ± 0.81 for left hands and 4.64 ± 0.60 for right hands (P > 0.05). The mean (± SD) reduction from baseline was (log10) 1.45 ± 0.50 for 4% chlorhexidine and 2.01 ± 0.98 for alcohol/chlorhexidine (P > 0.05). An alcohol/chlorhexidine hand rub was found to be as efficacious as a traditional scrub after 30 min; this study differs from previous work as it was undertaken in a population of practising anaesthetists in their working environment. The McKenzie method allows baseline and study evaluations to be performed contemporaneously on the same individual. Each subject was his/her own control. This method offers a more clinically relevant way to compare disinfectant solutions than standard methods.