Effectiveness of the McKenzie-based exercises in improving pain, disability, and cervical range of motion in patients with chronic non-specific neck pain: A systematic review with meta-analysis

The McKenzie Method is widely used in managing spinal pain; however, its effectiveness in chronic nonspecific neck pain (CNNP) remains uncertain.
To assess the effectiveness of the McKenzie Method compared to placebo, usual care, or other interventions in reducing pain, disability, and improving the cervical range of motion (CROM) in patients with CNNP.
A systematic review with meta-analysis was conducted in PubMed Medline, Scopus, Web of Science, CINAHL Complete, CENTRAL and PEDro up to July 2025. Randomized controlled trials including adults with CNNP treated with the McKenzie Method were analyzed. Random-effects meta-analyses calculated standardized mean difference (SMD) with 95% confidence intervals (95% CI). Heterogeneity (I2), sensitivityanalyses, publication bias, and certainty of evidence (GRADE) were assessed.
Eight studies (389 participants) were included. Low-quality evidence showed a large effect favoring the McKenzie Method for pain reduction (SMD =–0.57; 95% CI: −1.1 to −0.04; p = .034; I2 = 31.5%) and disability (SMD =–0.43; 95% CI: −0.90 to −0.01; p = .047; I2 = 19.5%). Publication bias was detected for disability, with trim-and-fill suggesting the true effect may be larger. Significant improvements in active CROM were observed for extension, flexion, and rotation, whereas no significant improvement was found for lateral flexion. No evidence of publication bias or sensitivity effects was found for these outcomes.
In adults with CNNP, interventions described as the McKenzie Method were associated with small improvements in pain, disability, and cervical flexion, extension, and rotation, with no clear effect on lateral flexion. Effects are short-term and of low certainty. Evidence for medium or long-term outcomes has not been reported based on studies retained in this review.

麦肯基疗法（McKenzie Method）在脊柱疼痛管理中应用广泛，但其针对慢性非特异性颈痛（chronic nonspecific neck pain, CNNP）的疗效仍不明确。
本研究旨在评估相较于安慰剂、常规护理或其他干预手段，麦肯基疗法在缓解慢性非特异性颈痛患者疼痛、改善残疾状态及提升颈椎活动度（cervical range of motion, CROM）方面的疗效。
本研究检索了截至2025年7月的PubMed Medline、Scopus、Web of Science、CINAHL Complete、CENTRAL及PEDro数据库，开展了一项系统综述与荟萃分析。对纳入接受麦肯基疗法治疗的慢性非特异性颈痛成人患者的随机对照试验进行分析。采用随机效应模型进行荟萃分析，计算标准化均数差（standardized mean difference, SMD）及95%置信区间（95% confidence intervals, 95% CI）。同时评估了异质性（I²）、敏感性分析、发表偏倚及证据质量（GRADE分级）。
最终纳入8项研究，共389名受试者。低质量证据显示，麦肯基疗法在缓解疼痛（SMD=–0.57；95%CI：−1.1~−0.04；p=0.034；I²=31.5%）及改善残疾状态（SMD=–0.43；95%CI：−0.90~−0.01；p=0.047；I²=19.5%）方面具有显著的正向效应。针对残疾结局检测到发表偏倚，通过修剪填充法分析提示真实效应可能更大。在颈椎主动活动度方面，伸肌、屈肌及旋转活动度均得到显著改善，而侧屈活动度无明显提升。针对上述结局指标未发现发表偏倚或敏感性影响。
针对慢性非特异性颈痛成人患者，以麦肯基疗法为代表的干预手段可小幅改善患者疼痛、残疾状态及颈椎屈、伸、旋转活动度，但对侧屈活动度无明确疗效。上述效应均为短期效应，且证据质量较低。本综述纳入的研究未报告中远期结局相关证据。