Back pain: The effect of physiological and educational treatment modalities on various outcome measures

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Science Teaching


James E. Graves


Exercise therapy, McKenzie therapy, Educational, Physiological, Back pain, Treatment modalities

Subject Categories

Medicine and Health Sciences | Public Health | Public Health Education and Promotion | Rehabilitation and Therapy


The purposes of this dissertation are to: examine the effect of McKenzie therapy and intensive exercise therapy on physiological as well as quality of life measures [physiological component]; and, to evaluate a self treatment resource for low back pain sufferers [educational component].

In the physiological component 18 chronic low back pain patients (nine male, nine female) underwent four weeks of McKenzie therapy. Nine of the eighteen subjects also performed intensive resistance training for the lumbar extensors. Repeated measures analysis of variance (ANOVA) revealed that four weeks of McKenzie therapy significantly improved (p < 0.05) 14 of the 17 variables measured. A single degree of freedom post-hoc contrast procedure was used to evaluate significant changes across time interval (pre-, mid-, and final testing periods). Analysis of co-variance (ANCOVA) revealed that mid and final means, based on adjusted pre-values, were not significantly different (p > 0.05) in individuals undergoing McKenzie only or McKenzie plus exercise therapy, in 16 of the 17 variables evaluated, therefore, data was pooled for further analysis. It was concluded that four weeks of McKenzie therapy was effective in significantly improving physiological as well as quality of life measures in chronic low back pain patients, with intensive exercise training adding no benefit.

In the educational component, 62 chronic low back pain sufferers (28 males, 34 females) read a self-help educational booklet Treat Your Own Back , and completed a written survey. A portion of the survey consisted of 25 T/F questions evaluating how much content the subjects learned/retained from the book. Subjects mean test score was 79 ± 1.5 percent correct. Additional analysis (by education level) revealed that subjects in the college educational group, scored significantly higher (p < 0.05) than subjects in the high school or post-graduate groups. Subjects also evaluated the book's content and what effect they felt the book had on their pain, belief in self-treatment, as well as a number of other factors. Mean scores for the content and effect questions were 4.2 ±.06, and 4.2 ±.08 respectively (mean responses above 3.5 were considered positive). Qualitative research findings suggest that subjects found the book to be well written and easy to understand, and that subjects were performing the exercises outlined in the book and being careful to maintain correct posture.


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