Perbandingan Pengaruh Dosis Kombinasi Ultrasound dan McKenzie terhadap Nyeri, Fleksibilitas, dan Kemampuan Fungsional pada Pasien Nyeri Punggung Bawah
Keywords:
ultrasound, McKenzie, low back pain, exercise dosage, ; flexibilityAbstract
Background: Low back pain (LBP) is a common musculoskeletal disorder associated with reduced lumbar flexibility and functional ability. Ultrasound and McKenzie exercise are commonly combined in physiotherapy; however, the optimal exercise dosage remains unclear.
Objective: This study compared the effects of two dosages of combined ultrasound and McKenzie exercise (10 repetitions × 2 sets and 10 repetitions × 3 sets) on pain, flexibility, and functional ability in patients with LBP.
Methods: A quasi-experimental pretest-posttest two-group design was conducted involving 40 patients with LBP aged 25–60 years and symptom duration of 4–24 months. Participants were divided into Group A (2 sets; n = 20) and Group B (3 sets; n = 20). Pain was assessed using the Visual Analogue Scale (VAS), lumbar flexibility using the Modified Schober Test (MST), and functional ability using the Oswestry Disability Index (ODI). Data were analysed using paired-samples and independent-samples t-tests at α = 0.05.
Results: Both groups demonstrated significant improvements in VAS, MST, and ODI scores (p < 0.001). Group B achieved greater improvements than Group A in delta VAS (3.08 ± 0.44 vs. 2.15 ± 0.40), delta MST (1.41 ± 0.31 vs. 0.86 ± 0.27), and delta ODI (18.20 ± 4.25 vs. 12.40 ± 3.02), with p < 0.001 for all outcomes.
Conclusion: Combining ultrasound with McKenzie exercise at 10 repetitions × 3 sets produced greater reductions in pain and greater improvements in lumbar flexibility and functional ability than the 2-set dosage in patients with LBP.
References
Almeida, M. O., Narciso Garcia, A., Menezes Costa, L. C., van Tulder, M. W., Lin, C.-W. C., & Machado, L. A. C. (2023). The McKenzie method for (sub)acute non-specific low back pain. Cochrane Database of Systematic Reviews, 2023(4), Article CD009711. https://doi.org/10.1002/14651858.CD009711.pub2
Cameron, M. H. (2018). Physical agents in rehabilitation: An evidence-based approach to practice (5th ed.). Elsevier.
Ebadi, S., Henschke, N., Forogh, B., Nakhostin Ansari, N., van Tulder, M. W., Babaei-Ghazani, A., & Fallah, E. (2020). Therapeutic ultrasound for chronic low back pain. Cochrane Database of Systematic Reviews, 2020(7), Article CD009169. https://doi.org/10.1002/14651858.CD009169.pub3
Fink, W., & Raffa, R. B. (2025). A pluripotent progression of the gate control system theory of pain: Modeling ascending and descending pain pathways as a Lotka-Volterra coupled control and feedback loop. Journal of Pain Research, 18, 4373–4385. https://doi.org/10.2147/JPR.S525449
GBD 2021 Low Back Pain Collaborators. (2023). Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5(6), e316–e329. https://doi.org/10.1016/S2665-9913(23)00098-X
George, S. Z., Fritz, J. M., Silfies, S. P., Schneider, M. J., Beneciuk, J. M., Lentz, T. A., Gilliam, J. R., Hendren, S., & Norman, K. S. (2021). Interventions for the management of acute and chronic low back pain: Revision 2021. Journal of Orthopaedic & Sports Physical Therapy, 51(11), CPG1–CPG60. https://doi.org/10.2519/jospt.2021.0304
Haile, G., Hailemariam, T. T., & Haile, T. G. (2021). Effectiveness of ultrasound therapy on the management of chronic non-specific low back pain: A systematic review. Journal of Pain Research, 14, 1251–1257. https://doi.org/10.2147/JPR.S277574
Hayden, J. A., Ellis, J., Ogilvie, R., Malmivaara, A., & van Tulder, M. W. (2021). Some types of exercise are more effective than others in people with chronic low back pain: A network meta-analysis. Journal of Physiotherapy, 67(4), 252–262. https://doi.org/10.1016/j.jphys.2021.09.004
Hennemann, V., Ziegelmann, P. K., Marcolino, M. A. Z., & Duncan, B. B. (2025). The McKenzie Method delivered by credentialed therapists for chronic low back pain with directional preference: Systematic review with meta-analysis. Journal of Manual & Manipulative Therapy, 33(2), 96–111. https://doi.org/10.1080/10669817.2024.2408084
Ingram, L. A., Tomkinson, G. R., d’Unienville, N. M. A., Gower, B., Gleadhill, S., Boyle, T., & Bennett, H. (2025). Mechanisms underlying range of motion improvements following acute and chronic static stretching: A systematic review, meta-analysis and multivariate meta-regression. Sports Medicine, 55(6), 1449–1466. https://doi.org/10.1007/s40279-025-02204-7
Kisner, C., Colby, L. A., & Borstad, J. (2018). Therapeutic exercise: Foundations and techniques (7th ed.). F. A. Davis.
Koivunen, K., Widbom-Kolhanen, S., Pernaa, K., Arokoski, J., & Saltychev, M. (2024). Reliability and validity of Oswestry Disability Index among patients undergoing lumbar spinal surgery. BMC Surgery, 24(1), Article 13. https://doi.org/10.1186/s12893-023-02307-w
Lam, O. T., Strenger, D. M., Chan-Fee, M., Pham, P. T., Preuss, R. A., & Robbins, S. M. (2018). Effectiveness of the McKenzie method of mechanical diagnosis and therapy for treating low back pain: Literature review with meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 48(6), 476–490. https://doi.org/10.2519/jospt.2018.7562
Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J. J. M., Tagliaferri, S. D., Brisby, H., Bowe, S. J., & Belavy, D. L. (2020). Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British Journal of Sports Medicine, 54(21), 1279–1287. https://doi.org/10.1136/bjsports-2019-100886
Rice, D., Nijs, J., Kosek, E., Wideman, T., Hasenbring, M. I., Koltyn, K., Graven-Nielsen, T., & Polli, A. (2019). Exercise-induced hypoalgesia in pain-free and chronic pain populations: State of the art and future directions. The Journal of Pain, 20(11), 1249–1266. https://doi.org/10.1016/j.jpain.2019.03.005
Vaegter, H. B., & Jones, M. D. (2020). Exercise-induced hypoalgesia after acute and regular exercise: Experimental and clinical manifestations and possible mechanisms in individuals with and without pain. Pain Reports, 5(5), Article e823. https://doi.org/10.1097/PR9.0000000000000823
Vlaeyen, J. W. S., Crombez, G., & Linton, S. J. (2016). The fear-avoidance model of pain. Pain, 157(8), 1588–1589. https://doi.org/10.1097/j.pain.0000000000000574
Wewege, M. A., & Jones, M. D. (2021). Exercise-induced hypoalgesia in healthy individuals and people with chronic musculoskeletal pain: A systematic review and meta-analysis. The Journal of Pain, 22(1), 21–31. https://doi.org/10.1016/j.jpain.2020.04.003
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