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Systematic Approaches to Rehabilitative Medical Treatment of Patients: A Review of Clinical Effectiveness and Guidelines

Last updated: November 9, 2018
Project Number: RC1042-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of systematic approaches to physical rehabilitation treatment?
  2. What are the evidence-based guidelines regarding systematic approaches to patients receiving physical rehabilitation treatment?

Key Message

Evidence of moderate to high quality from a systematic review of RCTs suggested that systematic approaches to rehabilitation medicine, specifically the McKenzie Method of Mechanical diagnosis and treatment (MDT), may be effective for reducing pain and disability for patients with acute or chronic low back pain. Comparative effectiveness in the included studies varied by comparator examined. In the systematic review and four RCTs there were no differences between MDT and comparators for any psychological constructs assessed (i.e., global perceived effect of treatment, kinesiophobia, and quality of life).Evidence of limited quality from one non-randomized study of patients with knee osteoarthritis who were waitlisted for surgery suggested that MDT may be an effective treatment approach. Patients diagnosed with derangement syndrome who were treated with MDT exercises experienced greater improvements in pain intensity, pain in daily living, and function in daily living than (i) patients diagnosed as not having derangement syndrome who were treated with standard exercises and (ii) undiagnosed patients in a waitlist condition.8 No evidence-based guidelines were identified regarding systematic approaches to physical rehabilitation treatment.