McKenzie Approach Research Articles

Effectiveness of Mckenzie Approach along with Tens (Transcutaneous Electrical Stimualtion) Modality for Low Back Pain among Sculptors

Effectiveness of Mckenzie Approach along with Tens (Transcutaneous Electrical Stimualtion) Modality for Low Back Pain among Sculptors

Comparison between Neural Mobilization and Mckenzie Approach in Reducing Pain, Improving Mobility and Functional Ability in Peoples with Lumbar Radiculopathy

Background: Lumbar radiculopathy is the compression of lumbar nerve root. The most common causes of nerveroot compression are intervertebral disc herniation and degenerative alterations. About 3% of cases, disc diseasecauses lumbar radiculopathy. Pain is the major symptom.Purpose: The study is to compare the effectiveness of neural mobilisation and McKenzie approach in reducingpain, improving mobility and functional ability for peoples with lumbar radiculopathy.Materials and Methods: A Experimental study which consists of 64 subjects who were selected based on inclusionand exclusion criteria from A.K.B physiotherapy during the period of November 2022 to April 2023. They weresplit into two groups , the Neural mobilisation group(n=32) and McKenzie group(n=32).The intervention wasgiven for 5 days a week for 4 weeks . The pre and post test values were measured using (NPRS), Modified Schober’smethod and (MODI).Results: With a p value of 0.0001, the mean of the Neural Mobilization at the post test was shown to be greaterthan the mean of McKenzie Exercise.Conclusion: This study concluded that Neural mobilisation was found to be more effective than McKenzie indecreasing pain , improving mobility and functional ability for peoples with lumbar radiculopathy.

Comparison Between Mckenzie Approach and Lumbar Core Stabilization Exercise in Improving Functional Activity and Reducing Pain for Lumbar Radiculopathy by Using Pain Rating Scale and Functional Scale as an Outcome Tool

Background: Lumbar radiculopathy, is a symptom of radiating pain in the lumbar nerve root distribution thatmay also include sensory and motor dysfunction. The most common causes of nerve root compression areintervertebral disc herniation and degenerative alterationsPurpose: To compare the effectiveness of McKenzie approach and core stabilization exercise in Lumbarradiculopathy by reducing pain and improving the functional activityMaterials and Methods: Total of 64 subjects will be selected by a convenient sampling method based on inclusionand exclusion criteria. The study was fully described to the participants, and their signed agreement was acquired.Numerical pain rating scale (NPRS), Roland-Morris Disability Questionnaire (RMDQ) was used to analyse thepain, and related disability.Results: With a p value of 0.0001, the mean of the core stabilization at the post test was shown to be greater thanthe mean of McKenzie Exercise.Conclusion: This study concluded that Neural mobilisation was found to be more effective than McKenzie indecreasing pain and functional ability for peoples with lumbar radiculopathy

Biceps-based 3-layer reconstruction of the irreparable rotator cuff: a technical note on biceps tendon as a common local graft for in-situ superior capsular reconstruction, partial cuff repair, and middle trapezius tendon transfer

BackgroundFor irreparable rotator cuff tears, 3-layer tendon reconstruction (in which in-situ superior capsular reconstruction-reinforced partial rotator cuff repair was augmented with hamstring-sheet-lengthened middle trapezius tendon transfer) was recently reported to achieve satisfactory postoperative outcomes. To avoid hamstring graft-related drawbacks, the current note describes a technical modification of that reconstruct; wherein long head of biceps tendon is used as a cornerstone structure for simultaneously reconstructing the superior capsule; lengthening the transferred middle trapezius tendon; and augmenting the partially-repaired rotator cuff.MethodsVia sub-pectoral approach, long head of biceps tendon is distally-tenotomized. Through McKenzie approach, proximal stump of the tenotomized long head of biceps is retrieved to the sub-acromial space where double-row biceps tenodesis (into a trough at the greater tuberosity) is performed for reconstructing the superior capsule. Next, postero-superior rotator cuff is partially repaired, and side-to-side sutured to the reconstructed capsule. Through a 7–8-cm skin incision over the medial scapular spine, middle trapezius tendon is released. Portion of long head of biceps tendon distal to the tenodesis site is retrieved via a sub-trapezius/sub-acromial corridor to the scapular wound where it is re-attached to the released middle trapezius tendon.ResultsUse of long head of biceps tendon as a common local graft (for simultaneously reconstructing the superior capsule, lengthening the transferred middle trapezius tendon, and augmenting the partially-repaired rotator cuff) is technically feasible provided that the harvested tendon stump is at least 10 cm in length.ConclusionWhile avoiding hamstring graft-related complications, the currently-reported biceps-based 3-layer rotator cuff tendon reconstruction might offer the advantages of reproducibility, safety, simplicity and quickness; however, it should be validated via further studies.Trial registration The present study was approved by the Institutional Committee of Scientific Research and Ethics (3-2023Orth10-1).

The McKenzie Method Is an Effective Rehabilitation Paradigm for Treating Adults With Moderate-to-Severe Neck Pain: A Systematic Review With Meta-Analysis.

Neck pain is a common musculoskeletal condition frequently managed with numerous conservative interventions. The McKenzie method of mechanical diagnosis and therapy (MMDT)is a form of physical therapy evaluation and treatment that aims to improve pain and disability in patients with musculoskeletal pain, including neck pain. To date, no systematic review with meta-analysis has examined the use of the McKenzie MMDT for neck pain. This study aimed to examine the effectiveness of the McKenzie MMDT in adult patients with neck pain. A systematic review and meta-analysis were performed using PubMed, ScienceDirect, MEDLINE, CINAHL, Web of Science, and Google Scholar. Full search terms were "McKenzie method" OR "McKenzie approach" OR "McKenzie treatment" AND "neck pain." Inclusion criteria were the use of the McKenzie MMDT, level I randomized control trials (RCTs), adults, and outcomes of pain (0-10 scale) and disability (neck disability index). A total of 11 RCTs met the final selection criteria from 1,955 articles on initial search with 289 patients receiving the McKenzie MMDT out of 677 total patients. For meta-analysis, there was a clinically insignificant but statistically significant improvement in pain (1.14/10 points) in patients receiving the McKenzie MMDT versus control interventions (p<0.02). There was no significant improvement in the neck disability index score between the McKenzie MMDT versus control interventions (p=0.19). For severity of pain, there was a clinically and statistically significant improvement in moderate or severe pain (2.06/10 points; p<0.01), but not in mild-to-moderate pain (p=0.84) when comparing the McKenzie MMDT to control interventions. Overall, the McKenzie MMDT provides very small but statistically significant improvements in neck pain of all severity compared to control interventions. However, the McKenzie MMDT does provide clinically and statistically significant pain improvement in moderate-to-severe neck pain. Use of the McKenzie MMDT did not provide any significant improvement in disability compared to control interventions. This study is the first systematic review with meta-analysis on the effectiveness of the McKenzie MMDT for adult patients with neck pain.

A comparative study of mckenzie approach versus mulligan mobilization with a common use of if in the management of lumbar disc prolapse

The purpose of this study was to compare the effectiveness of McKenzie's approach versus Mulligan's mobilization with the common use of interferential therapy in the management of Lumbar disc prolapse. Thirty (30) individuals; aged between 20 to 45 years, presenting with prolapse inter vertebral disc with symptom duration within one month, were randomized into two groups. Group-A received the McKenzie approach with interferential therapy and Group B received Mulligan mobilization with interferential therapy. The treatment duration was four weeks. Data was obtained on pain intensity levels i.e. visual analogue scale (VAS) and level of functional disability, Oswestry disability index (ODI). The mean score of ODI reduced from a mean of 37.8667 to 29.4667 in group-A (McKenzie approach with interferential therapy group) whereas in group B (Mulligan mobilization with interferential therapy) the mean score has been improved from 38.2667 to 16.8. The pain and disability score analysis within both group A (P= 5.9x10-07) and group B (P=1.7x10) shows significant improvement while inter-group comparison shows significant improvement in group-B subjects as compared to group-A (p=9.9x10-10). The mean score of VAS had improved from a mean of 6.78667 to 4.44; mean in group-A (McKenzie approaches with interferential therapy group) whereas in group B (Mulligan mobilization with interferential therapy group) The mean score of VAS had improved from a mean of 6.98667 to 2.62; The score analysis for intergroup comparison showed the strength significantly improved in group-B subjects as compared to group-A subjects (p=5.17703 X 10-6). The results of this study demonstrate that Mulligan SNAGs with interferential therapy is a superior treatment approach as compared to McKenzie's approach with interferential therapy in managing Lumbar disc prolapse.

Effectiveness of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: An experimental study.

This study "Effectiveness of Mckenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome: an experimental study" was conducted to study and find the effectiveness of Mckenzie approach and segmental spinal stabilization exercises on reduction of pain, correction of rounded shoulder, and disability. Pain, disability, and rounded shoulders are the major limiting factors as it affects the quality of life and reduces efficiency and social participation. The study was conducted among 120 individuals with cervical postural syndrome, and fulfilling the inclusion and exclusion criteria was included. The outcome measures were Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Vernier caliper to evaluate pain, functional disability, and rounded shoulder, respectively. Subjects were randomly divided into two groups, Group A and Group B, by using SPSS software. Interventional training was given for 6 weeks to the patients. Group A subjects were given spinal stabilization exercises. Group B subjects were given Mckenzie approach. The statistical analysis was performed using SPSS; pre-test and post-test were used to calculate the results, followed by data presentation and analysis. The result showed that at the end of the 6 weeks on comparison between pre- and post-intervention of Group A and Group B, both the techniques were effective, but group B was significantly effective than Group A. It was noted that McKenzie approach and segmental spinal stabilization exercises were effective on neck pain in individuals with cervical postural syndrome, but on comparing both techniques, Mckenzie protocol is more beneficial than segmental spinal stabilization exercises. The study accepts the alternate hypothesis that there is significant effect of McKenzie approach and segmental spinal stabilization exercises on neck pain in individuals with cervical postural syndrome.

The association between self-efficacy on function and pain outcomes among patients with chronic low back pain managed using the McKenzie approach: a prospective cohort study

ABSTRACT Introduction Self-efficacy is a determinant of function and pain outcomes in patients with chronic low back pain receiving physiotherapy. The McKenzie approach is an effective intervention for patients with back pain that may affect self-efficacy. Study aims were to determine if, among patients with back pain being managed by McKenzie-credentialed physiotherapists: intake self-efficacy is correlated with intake function and pain; intake self-efficacy is associated with changes in function and pain during treatment; self-efficacy improves during treatment; and improvements in self-efficacy during treatment are associated with improvements in function and pain at discharge. Methods Two-hundred-eighty-two subjects with chronic low back pain seen by McKenzie-credentialed clinicians provided data on self-efficacy, function and pain at intake and discharge. Results Self-efficacy was correlated with function and pain at intake; however, intake self-efficacy was not associated with function or pain outcomes. Self-efficacy increased during treatment. This increase was associated with improvements in function and pain at discharge. Conclusion While intake self-efficacy was associated with function and pain when initiating physiotherapy, it did not result in improved treatment outcomes. Specific interventions may be necessary to improve self-efficacy. The increases in self-efficacy observed during treatment were associated with improvements in function and pain outcomes at discharge.

Manual Therapy Followed by Dynamic Strengthening Exercise Along With Conventional Physiotherapy Versus Manual Therapy Along With Conventional Physiotherapy on The Improvement of Pain and Functional Disability In Patients With Chronic Non-Specific Low Back Pain: A Randomized-Controlled Pilot Study

Chronic low back pain (LBP), defined as back pain persisting for more than 12 weeks, affects over 50% of the general population.[1] It is the second most common factor for patients in search of primary care services.[2]According to the US National Center for Health Statistics, 14% of new patients admitted to a hospital for treatment had low back pain, representing 13 million people.[3] Also, it is estimated that over 70% of adults have had at least one episode of LBP in their lifetime.[4]In 2007, another study revealed that lower back region pain is caused by disc degeneration, spondylolisthesis, lumbar stenosis, epidural hematoma, and other causes, and 3% of all patients discharged from hospitals have symptomatic low back pain.[5] Because the causes of LBP are variable, different exercise regimens have been used to treat patients, including lumbar flexion, extension, isometric flexion, passive extension, and intensive dynamic back exercise regimens, and many of these exercise regimens have not yielded satisfactory results.[6]Recently, some studies have focused on exercises that aim to maintain or improve lumbar spine stability, such as lumbar stabilization exercises, which are aimed at improving the neuromuscular control, strength, and endurance of the muscles that are fundamental to maintaining spinal and trunk stability through several groups of muscles, particularly transverse abdominis and lumbar multifidi, but also other paraspinal, abdominal, diaphragmatic, and pelvic muscles.[7] Unsubstantiated suggestions that stabilization training may be useful in reducing pain and disability for all patients with nonspecific LBP, have appeared in the literature,[8] but these assertions have not been definitively demonstrated. Weakness of the abdominal muscles among the trunk muscles of low back pain patients is generally prevalent, and the strengthening of the abdominal muscles is essential in the recovery of the spinal neutral position.[9] When imbalance between the abdominal muscles of the trunk and extensor muscles occurs, it triggers slow back pain and reduces stabilization of the lumbar.[10]The ability to actively control the muscles of the hip plays an important part in lumbar segmental stability. If the sacroiliac joint moves excessively, it results in pressure on the joints and disks between the L5–S1 vertebral body, sacroiliac joint, and pubic symphysis, which leads to functional failure of the sacroiliac joint and low back pain. This causes the gluteus maximus muscle to contract, creating a self-locking mechanism, thereby providing stability to the sacroiliac joint.[11]There are various forms of exercise that can be prescribed based on different schools of thought, which include intensive dynamic back extensor exercises (motor control exercises), yoga and aerobic exercises.[12]Graded strengthening exercises are aimed at improving the neuromuscular control, strength, and endurance of the muscles that are central to maintaining dynamic spinal and trunk stability. The effect of graded lumbar stabilization exercises has been studied in subjects with recurrent LBP (8). Dynamic strengthening exercises can strengthen the spinal column and supporting structures.[13] An electromyography study to compare recruitment of the rectus abdominis and erector spinae muscles during dynamic strengthening exercise revealed higher muscle activity in these muscles.[14]Therefore, the aim of this study is to compare the effects of graded lumbar strengthening exercises and lumbar dynamic strengthening exercises on the maximal isometric contraction strength of the lumbar extensors, pain severity, and functional disability in patients with nonspecific chronic LBP. According to many studies, the first step of the physiotherapy treatment pyramid is education of the patient.[15] In another study, researchers explored several research studies that included evidence on conservative treatments,[16] which included manual therapy or conservative physiotherapy, which included exercises, mobilization, McKenzie approach treatment, manipulation, strengthening programs, advice, and other manual therapy techniques, which have strong evidence of effectiveness for chronic low back pain patients.[17] According to a study,[18] rest and exercise are effective for low back pain patients.

Rotator cuff irreparability or failure of repair (re-tear): technical note on middle trapezius tendon transfer for reproduction of supraspinatus function

PurposeBased on its close anatomic features and nearly-collinear force vector to those of supraspinatus muscle, the current article describes a technique of middle trapezius tendon transfer for reproduction of supraspinatus function in the context of rotator cuff irreparability/re-tear management.MethodsWhile seating the patient in beach-chair position, arthroscopic gleno-humeral examination and sub-acromial decompression are initially performed. Hamstring tendons are harvested and fashioned as flattened quadruple sheet. Through McKenzie approach, infraspinatus and subscapularis tendons are repaired. Then, medial half of middle trapezius insertion tendon is harvested from most medial 5-6 cm of the scapular spine. Through McKenzie approach, hamstring sheet is retrieved via a sub-trapezius/sub-acromial corridor from the scapular wound. Hamstring sheet is re-attached to cuff footprint by double row/suture bridge repair configuration. While retracting the scapula and placing gleno-humeral joint in 45O-abduction/45O-external rotation, hamstring sheet is re-attached to released middle trapezius tendon by non-absorbable sutures. Finally, tendon reconstruct is dynamically-tested in different positions of range of motion.ResultsTransfer of medial portion of middle trapezius insertion tendon (lengthened by interposition hamstring tendon sheet) to cuff footprint was technically feasible. Dynamic testing showed smooth sub-acromial gliding motion of the tendon reconstruct.ConclusionFor reproduction of supraspinatus function, hamstring tendon augmented-middle trapezius tendon transfer to cuff footprint heralds a number of technical and biomechanical advantages; thus offering a potential effective modality of cuff irreparability/re-tear management in relatively young patients of high functional demands. However, current description should be investigated in further biomechanical and clinical studies to validate its long-term outcomes.

Comparison of Mckenzie approach versus Lumbar Stabilization Exercises in the treatment of chronic low back pain

Introduction: Lumbar stabilization and McKenzie exercises are becoming a popular trend for managing chronic low back pain though it is currently not known whether lumbar stabilization exercises produce better results in improving functional status compared to McKenzie approach. The purpose of this study was to determine the effectiveness of the McKenzie approach versus lumbar stabilization in the treatment of chronic low back pain. Material &amp; Methods: This was a randomized controlled trial. Lottery method was used to randomly divide individuals who fulfilled inclusion criteria into 2 groups. Assessments of the patients were done in OPD. Baseline assessment was done on day 1 and post intervention assessment was done after 2 weeks. A total of 8 treatment sessions spread across 2 weeks were given (4 days per week). Data were assessed at baseline level and post intervention. Data was entered and analysed by SPSS version 21. Results: A total of 28 females and 02 males (mean age of 50.88 ±12.29) participated in the study. After 02 weeks of intervention, both treatment groups showed improvement in decreasing pain and improving functional status. The lumber stabilization group showed significant gains on Numeric Pain Rating Scale and (p=0.001) and Modified Oswestry Disability Index (p=0.001) compared to the Mckenzie group. Conclusion: Patients in both lumber stabilisation and McKenzie groups showed significant improvement, however, the patients in lumbar stabilization group were superior than the patients in McKenzie group on the selected outcomes.

Effects of McKenzie Approach and Kinesio Taping Technique in Individuals with Mechanical Low Back Pain: A Comparative Study

Objective of this study is to compare the effects of McKenzie approach and kinesio taping technique in individuals with mechanical low back pain. Materials and Methods used are, Quasi experimental study design in the study setting of Department of Physiotherapy, Kovai Medical Centre and Hospital, Coimbatore with the sample of the 20 Patients with Mechanical low back pain who met the inclusion criteria were selected for the study. They were Grouped in A and B with each of 10 Patients. Among the patients, Group A received McKenzie approach and Group B received Kinesio taping. Patients were measured for Pain status by Visual Analogue Scale, Functional ability by Modified Oswestry Disability Index Scale. Results of the data were analyzed using paired, and independent “t‟ tests at 5% level of significance. Even though, there was a significant improvement in both the groups, the McKenzie approach group showed a greater improvement when compared to Kinesio taping technique group. We conclude that McKenzie approach is more effective therapy for mechanical low back pain patients. KEY WORDS: Mechanical low back pain, McKenzie approach, Kinesio taping technique.

Efficacy of McKenzie Manipulative Therapy on Pain, Functional Activity and Disability for Lumbar Disc Herniation

Introduction: Lumbar disc herniation (LDH) is a common determinant of low back pain (LBP) and priority for cost-effective therapeutic approach is necessary. The objective of the study was to explore the effectiveness of McKenzie Manipulative Therapy (MMT) for patients with LDH. Methodology: This was an assessor blinded, 36-month RCT, at Center for Rehabilitation of the Paralyzed (CRP) in Savaar, Bangladesh. Seventy-two subjects, ages 28-47 years and clinically diagnosed with MRI findings of LDH, were randomly recruited from hospital records and sixty-eight found eligible. The control group received stretching exercise and graded oscillatory mobilization, and the experimental group received McKenzie manipulative therapy for 12 sessions in 4 weeks, both groups received a standard set of care also. The pain was the primary outcome and the secondary outcome was participation in functional activities and disability. Results: Pain and Disability found significant improvement in both groups, with the McKenzie approach significantly superior to the control group (p&lt;.05). Bothersome in Activities (SBI) reported significantly lower post report compared to baseline for both groups (p&lt;.01). McKenzie showed significantly superior outcomes for fear avoidance (FABQ) total and SBI feeling of abnormal sensation in leg compared to the control group (p &lt;.05). Conclusion: The McKenzie manipulative therapy approach was found to be effective for pain, disability and participation in activities for single or multiple level LDH patients in a short time from day 1 to week 4, and the treatment effect extends after 6 months. Clinical Trial Registration No.: CTRI/2020/ 04/024667.

Cognitive behavioural interventions, and function and pain outcomes among patients with chronic neck pain managed with the McKenzie approach.

Graded activity and graded exposure in vivo are recommended cognitive behavioural approaches to improve function and pain outcomes for patients receiving physiotherapy for chronic nonspecific neck pain. The McKenzie method is a common treatment approach for patients with neck pain. The study objectives were to examine associations between interventions with graded activity and/or graded exposure, as determined by the treating physiotherapist, and function and pain outcomes for patients with chronic nonspecific neck pain managed by clinicians with credentials in the McKenzie approach. A cohort study was carried out, in which subjects (n = 366) with chronic nonspecific neck pain completed intake surveys (i.e., the Neck Functional Status Computerized Adaptive Test and the Numeric Pain Rating Scale), and questions related to their demographic, lifestyle and health status. Treatment with graded activity/graded exposure during the episode of care was recorded. Function and pain measures were repeated at discharge. Multivariable models examining associations between patients receiving versus not receiving graded activity/graded exposure, and pain and function outcomes were constructed, controlling for potential confounding effects. Despite statistical significance, there were no clinically relevant differences between treatment versus no treatment with graded activity/graded exposure, and function or pain outcomes. There is insufficient evidence to suggest that patients being managed with McKenzie methods will attain clinically relevant improvements in function or pain outcomes when augmenting treatment with graded activity and/or graded exposure when the choice to intervene with these cognitive behavioural approaches is determined by the treating physiotherapist.

Effect of McKenzie Approach and Neck Exercises on Forward Head Posture in Young Adults

Effect of McKenzie Approach and Neck Exercises on Forward Head Posture in Young Adults

Distribution of the McKenzie Syndromes and pelvic girdle pain in pregnancy-related back pain

This study investigated the distribution of the three McKenzie syndromes and pelvic girdle pain (PGP) among participants with pregnancy-related back pain (BP) attending some selected medical facilities. The aim was to determine if pregnancy-related BP can be classified into the three McKenzie syndromes and also to find out the distribution pattern of PGP among the participants. Participants were recruited into the study consecutively and were assessed using the McKenzie assessment protocol and pelvic girdle pain provocative tests. Participants with low back pain (LBP) or high back pain (HBP) were classified into the three McKenzie syndromes and those with PGP were classified according to their pain site. Data were analysed using descriptive and inferential statistics. Alpha level was set at 0.05. The participants with HBP had the lowest mean age (26.2 ±5.6 years). There was a significant difference in the mean age of the participants across the three BP groups (F = 3.9525; p = 0.0199). Among the participants with LBP, derangement syndrome constituted 95.7% and postural syndrome 4.3%. All the participants with HBP had derangement syndrome. Bilateral pain was present in 62% of the participants with PGP. Derangement syndrome was predominant among participants with LBP and HBP while bilateral pain presentation is prevalent among the participants with PGP. It is recommended that the McKenzie approach should be promoted and used in the physical assessment of women with pregnancy-related back pain. Keywords: McKenzie syndromes, pelvic girdle pain, pregnancy-related back pain

Short-term effects of Mckenzie vs. motor control approach for patients with chronic low back pain and a derangement classification

Short-term effects of Mckenzie vs. motor control approach for patients with chronic low back pain and a derangement classification

Science in the performance stratum: hunting for Higgs and nature as performance

Recent traditions such as posthumanism and new materialism propose that non-humans and matter are active participants in processes of signification, so that humans do not give meaning to matter, but matter and meaning co-constitute each other. Notably, Karen Barad's plea for ‘the study of practices of knowing in being’ implies that performativity – with its conforming as well as its norm-shifting effects – is situated at the very heart of both scientific work itself and engagements with it. Understanding how matter and meaning are entangled requires a shift in focus from the relationship between them as it has come about towards the ‘processual relating’ within which this relationship comes about. This means to study the identities and subjectivities of entities in the laboratory as they are ‘in the making’. Following performance studies scholar Jon McKenzie, we argue that this ‘processual relating’ takes place under the pressure to perform, or else. Read in tandem with Barad, McKenzie's approach to performance in terms of a challenge (of being challenged to ‘perform, or else’) raises the question of whether in scientific experiments not only scientists and technology are put under pressure, but also nature itself is required to ‘perform, or else’. Using the hunt for the Higgs particle at the European Organization for Nuclear Research (CERN, Geneva) as our case study, we will show the productivity of this perspective as it was first developed within the humanities not only for understanding human bodies and by extension of what it means to be human, but also for our understanding of knowledge production in the sciences. Furthermore, we suggest that such understanding may provide a useful perspective on the transformations in research and knowledge production currently brought about by the rise of the Digital Humanities.

A classification and treatment protocol for low back disorders Part 2 – Directional preference management for reducible discogenic pain

Background: It has been widely recommended that clinical trials on people with low back disorders should have a greater focus on subgroup specific treatment in order to increase the likelihood of clinically meaningful effects being demonstrated. The McKenzie approach to assessing and treating patients with a directional preference is a potentially useful and widely used clinical method in providing specific treatment. Studies to date have not used a clearly defined and appropriately detailed clinical protocol for the McKenzie approach that is reproducible in the clinical or research setting.Objectives: This paper presents a detailed classification and treatment protocol for people with clinical features thought to be indicative of reducible discogenic pain with a directional preference that is responsive to mechanical loading strategies.Discussion: A pathoanatomical interpretation of the McKenzie approach, classification principles and particular treatment components in the clinical protocol are discussed.Conclusion: The described clinical protocol will be used in the Specific Treatment for Problems of the Spine trials comparing specific physiotherapy to evidence-based advice.

Effectiveness of Symptom Guided Therapeutic Approach in Treating Discogenic Pain with Radiculopathy Using a Combination of Directional Preference Exercises, Mobilisation and Neural Mobility Exercises — A Case Report

Researchers have reported various therapeutic approaches to treat patients with low back pain. The mechanical diagnosis and therapy as proposed by McKenzie, has been shown to be effective in diagnostic, therapeutic and prognostic inference. Most often, the treatment options considered in these studies was directional preference exercises and manual procedures utilising movement and positions. But the effectiveness of symptom guided therapeutic approach in treating discogenic low back pain with radiculopathy using directional preference exercises, mobilization and neural mobility exercises is unknown. A case of a forty three-year-old male presenting with discogenic low back pain along with radiculopathy was assessed with McKenzie approach. Appropriate treatment strategy was selected and prescribed based on the initial assessment. The patient was re-evaluated each session, and treatment modification was made according to his symptom presentation during each visit. He proved to be symptom free after seven visits. This could have been due to disc regression and enhanced neural mobility obtained due to treatment. This case report demonstrates the effectiveness of symptom guided therapeutic management to treat patients with discogenic low back pain along with radiculopathy using appropriate treatment strategies. Finally, the report summarizes the treatment offered and discusses the possible explanation of the specific treatment strategies implemented.