EFFECTS OF MCKENZIE VERSUS ELDOA TECHNIQUE ON PAIN AND SPINAL MOBILITY IN PATIENTS WITH ANKYLOSIS SPONDYLITIS: A RANDOMIZED CLINICAL TRIAL

Abstract

Background: Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disorder characterized by persistent spinal pain, stiffness, restricted spinal mobility, and impaired physical function. Exercise-based physiotherapy constitutes an important component of rehabilitation; however, comparative evidence regarding the effects of McKenzie Extension Exercises and ELDOA exercises in individuals with AS remains limited.

Objective: To compare the effects of McKenzie Extension Exercises and ELDOA (Elongation Longitudinal avec Decoaptation Osteo-Articulaire) exercises on pain intensity, spinal mobility, functional ability, and disease activity in patients with ankylosing spondylitis.

Methods: A randomised controlled trial was conducted among 52 patients with AS aged 18–40 years recruited from selected physiotherapy settings in Lahore, Pakistan. Participants were randomly allocated into two equal groups. Group A received McKenzie Extension Exercises, whereas Group B received ELDOA exercises. Both groups additionally received conventional physiotherapy for 12 weeks, with three treatment sessions per week. Pain intensity, functional ability, disease activity, and spinal mobility were assessed using the Numeric Pain Rating Scale (NPRS), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and Modified Schober Test, respectively. Within-group changes were analysed using paired-samples t-tests, while between-group differences in change scores were assessed using independent-samples t-tests. Statistical significance was established at p < 0.05.

Results: Both groups demonstrated statistically significant improvements in all outcome measures following the 12-week intervention (p < 0.001). In Group A, mean NPRS scores decreased from 6.80 ± 0.90 to 3.83 ± 1.05, BASFI scores from 5.36 ± 0.89 to 3.52 ± 0.96, and BASDAI scores from 5.49 ± 0.78 to 3.67 ± 0.96, while Modified Schober measurements increased from 3.48 ± 0.61 to 5.00 ± 0.67. In Group B, NPRS scores decreased from 6.08 ± 0.81 to 3.91 ± 0.88, BASFI scores from 4.96 ± 0.69 to 3.43 ± 0.94, and BASDAI scores from 5.50 ± 0.81 to 4.04 ± 1.00, whereas Modified Schober measurements increased from 3.10 ± 0.65 to 4.29 ± 0.68. Between-group analysis demonstrated statistically significant differences in change scores for NPRS (p < 0.001), BASFI (p = 0.030), BASDAI (p = 0.020), and Modified Schober Test (p = 0.008).

Conclusion: Both McKenzie Extension Exercises and ELDOA exercises, when combined with conventional physiotherapy, were associated with significant improvements in pain intensity, spinal mobility, functional ability, and disease activity among patients with ankylosing spondylitis. The significant between-group differences indicate differential effects of the two exercise approaches across the assessed outcomes, supporting their consideration within structured physiotherapy-based rehabilitation programmes for AS.