Effects of McKenzie and Proprioceptive Neuromuscular Facilitation Exercises on Mechanical Low Back Pain in Middle-Aged Patients

Abstract

Objective: Mechanical low back pain (MLBP) is highly prevalent among middle-aged adults and contributes substantially to disability and reduced quality of life. Exercise-based rehabilitation remains a core conservative management strategy. However, evidence directly comparing McKenzie exercise and proprioceptive neuromuscular facilitation (PNF) exercise in middle-aged populations remains limited. This study compared the effects of McKenzie and PNF exercises on pain intensity, lumbar range of motion (ROM) and functional disability in middle-aged adults with MLBP. Methodology: A 6-week quasi-experimental study was conducted among 30 participants aged 40–65 years with MLBP. Participants were allocated to either a McKenzie exercise group (n=15) or a PNF exercise group (n=15). Both groups received 18 supervised treatment sessions over 6 weeks. Outcome measures were assessed at baseline, week 3 and week 6. Pain intensity was measured using the Numeric Rating Scale (NRS), lumbar ROM using the Modified-Modified Schober Test and fingertip-to-floor test and functional disability using the Oswestry Disability Index (ODI). Repeated-measures analysis of variance and Bonferroni post hoc analysis were used for statistical analysis. Results: Both groups demonstrated significant improvements over time in pain intensity, lumbar ROM, and functional disability (P<0.01). A significant between-group difference was observed for pain reduction at week 6 favoring the McKenzie group (mean difference, 0.733; 95% confidence interval, 0.032–1.435; P=0.041). No significant between-group differences were identified for lumbar ROM or ODI outcomes (P>0.05). Conclusion: The findings of the present study demonstrate that both interventions are effective conservative rehabilitation strategies for middle-aged adults with MLBP. Significant improvements were observed in pain intensity, lumbar mobility, and functional disability following 6 weeks of supervised intervention. McKenzie exercise demonstrated superior effectiveness for pain reduction compared with PNF exercise, suggesting that repeated directional movement and self-management strategies may provide enhanced analgesic benefits in this population.