Comparison between the Effectiveness of McKenzie Extension Exercises and William Flexion Exercises for Treatment of Acute or Sub-acute Low Back Pain

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Karez Namiq Kakarash
Vian Afan Naqshbandi


Back Pain, Exercise, McKenzie Extension, William Flexion


Background: Acute low back pain is one of the leading causes of work absences throughout the world. People from low- and middle-income countries faced more low back pain compared to developed countries. This is because they work physically and prefer to use manually carrying objects by hand. One of the effective treatments for acute low back pain is exercise.
The current study aims to compare the effectiveness of the McKenzie Extension Exercise to William Flexion Exercise for patients with acute low back pain and or sub-acute low back pain in Erbil City.
Methods: Quasi-experimental comparative trial of pre-post study design was conducted. Patients were recruited from the physiotherapy department of Rzgary Teaching Hospital, Iraq from October 17th, 2021 to December 1st, 2022. The patient seeking care for acute or sub-acute low back pain visited the physiotherapy department at Rzgary teaching hospital. Eligible participants were assigned to receive management based on the McKenzie group receiving exercises according to physical examination at least Five times a day and the William group receiving exercises at least Three times a day. Primary outcome measures include pain (0-10 Numerical Rating Scale NRS) over the First week at Three-week, pain at Three months, and level of disability (0- 24 Roland Morris Disability Questionnaire RMDQ) over the First week, three weeks and at Three months treatment effect was estimated.
Result: One Hundred and Twenty participants were recruited and all of them completed the program. An Independent sample t-test was applied to compare the mean NRS score of two
treatment groups before treatment and after treatment. The P-value for the independent sample t-test (0.89) shows that there is a non-significant difference in mean NRS between the two treatment groups before treatment. The P-value for the independent sample t-test (< 0.001) shows that there is a highly significant difference in mean NRS between the two treatment groups after treatment. The P-value for the independent sample t-test (0.568) shows that there is a non-significant difference in mean RMDQ between the two treatment groups before treatment. The P-value for the independent sample t-test (<0.001) shows that there is a highly significant difference in mean RMDQ between the two treatment groups after treatment.
Conclusion: In the present study it was found that McKenzie Extension Exercise produced a significant effect in managing acute and sub-acute low back pain in adult patients. Furthermore, William Flexion Exercise has a significant impact on managing patients with acute low back pain, while, this impact is lower than McKenzie Extension Exercise.

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