RESEARCH: Virtual McKenzie extension exercises for low back and leg pain: a prospective pilot exploratory case series • Posts by EIM | Evidence In Motion Skip To Content

RESEARCH: Virtual McKenzie extension exercises for low back and leg pain: a prospective pilot exploratory case series

July 8, 2022 • Research • Adriaan Louw, Terry Cox

The EIM’s pain team is publishing again! This paper explored whether or not a motor imagery directional preference approach would result in any changes in patients with LBP and leg pain.

Abstract
Introduction: Current evidence supports the inclusion of directional preference exercises for a subgroup of patients with low back (LBP) and leg pain. Recent pain neuroscience strategies have suggested that cortical restructuring associated with movement activating the body map representation in the brain might account for the observed improvement with the directional preference approach.

Objectives: To explore whether or not a motor imagery directional preference approach would result in any changes in patients with LBP and leg pain.

Methods: A consecutive convenience sample of patients with LBP and leg pain were recruited at two outpatient physical therapy clinics. Measurements of LBP, leg pain, fear-avoidance beliefs (FABQ), pain catastrophizing (PCS), active lumbar flexion, and straight leg raise (SLR) were compared before and immediately after a virtual (motor imagery) directional preference exercise.

Results: Statistically significant differences for LBP, FABQ, PCS, active lumbar flexion, and SLR were observed, but only SLR changes met or exceeded the minimally clinically important difference (MCID).

Conclusions: A brief virtual motor imagery extension treatment yielded some immediate positive shifts in patients presenting to physical therapy with LBP and leg pain. Our results indicate that randomized comparison trials are needed to determine the effect of this intervention on the short- and longer-term outcomes in patients with LBP and leg pain.

Citation:
Adriaan Louw, Kevin Farrell, Anthony Nielsen, Max O’Malley, Terry Cox & Emilio J. Puentedura (2022) Virtual McKenzie extension exercises for low back and leg pain: a prospective pilot exploratory case series, Journal of Manual & Manipulative Therapy, DOI: 10.1080/10669817.2022.2092822

Adriaan Louw

Adriaan earned both an undergraduate as well as a master’s degree in physiotherapy from the University of Stellenbosch in Cape Town, South Africa. He is an adjunct faculty member at St. Ambrose University, South College and the University of Nevada Las Vegas, teaching pain science. Adriaan has taught throughout the US and internationally for 20...

Terry Cox

Terry initially earned his Bachelor’s in Education, prior to completing his Bachelor’s in Physical Therapy in 1987. He continues to combine his two passions by actively pursuing opportunities to teach and mentor the next generation of clinicians. Current Roles: Faculty, Southwest Baptist University Faculty, EIM Research: Treatment of Patients with Degenerative Cervical Radiculopathy Using a...

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