The research by Lam et al. titled, “Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating Low Back Pain: Literature Review with Meta-analysis” is another illustration of how difficult it is to demonstrate evidence of effectiveness of our rehab interventions.
One contributing factor is the heterogeneity of the outcome tools and measures applied. Another factor is the limited use of outcomes in the impairment and objective performance domains. Studies comparing the effectiveness of interventions using only outcomes in the symptom and subjective performance (such as self-reported disability questionnaires) domains will continue to provide conflicting evidence. Only a weak to moderate association exists between the four different outcome domains. Stronger associations exist between the symptom and subjective performance domains; and between the impairment and objective performance domains. Additionally, improvements in the symptom and subjective performance domains are less related to the specificity of the intervention and more related to the clinician and patient buy-in of the provided interventions.
To deliver value to our patients, researchers and clinicians alike must strive to provide interventions/grouping of interventions that deliver outcomes in all four outcome domains.
It’s Time We Step Up!
MET’s MET-odology provides an organized framework for your clinical interventions to deliver optimal outcomes in all 4 domains.