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

Mbada, CE, Makinde, MO, Odole, AC, Dada, OO, Ayanniyi, O, Salami, AJ and Gambo, IP (2019) Comparative effects of clinic- and virtual reality-based McKenzie extension therapy in chronic non-specific low-back pain. Human Movement, 20 (3). pp. 66-79. ISSN 1732-3991

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Abstract

Purpose. The 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. Methods. This quasi-experimental study involved 46 patients (CbMT: n = 24; VRG: n = 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 4th and 8th 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 = 0.05. Results. There were no significant differences in the treatment outcomes (mean change) across the groups (p > 0.05), except for kinesiophobia, where VRG led to a significantly higher decline in mean rank at week 4 (28.3 vs. 19.1; p = 0.018) and 8 (28.7 vs. 18.7; p = 0.009), and vitality (a general health status item) at week 4 (27.6 vs. 19.8; p = 0.042) and 8 (28.1 vs. 19.3; p = 0.042). ANCOVA showed that significant baseline parameters were not significant predictors of vitality (F = 1.986; p = 0.070) or kinesiophobia (F = 0.866; p = 0.563) outcomes. Conclusions. The 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.