Published date:Mar 13 2025

Journal Title: Journal of Spine Practice

Issue title: Journal of Spine Practice (JSP): Volume 4, Issue 2

Pages:18 - 27

DOI: 10.18502/jsp.v4i2.17017

Yazid Maghrabiyazid.maghrabi@gmail.comDepartment of Neuroscience, Ministry of the National Guard-Health Affairs, Jeddah

Lamair Albakrilamir_albakri@hotmail.comDivision of Neurosurgery, Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah

Hana Alsebaeylhsobayel@ksu.edu.saDepartment of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh

Saleh Baeesasbaeesa@kfshrc.edu.saDivision of Neurosurgery, Neurosciences Department, King Faisal Specialist Hospital and Research Center, Jeddah

Introduction

Khan Kinetic Treatment (KKT) utilizes high-frequency, small-amplitude sinusoidal waves to activate neuromuscular structures to treat neck and back pain. It integrates biomechanics, physical therapy, and neurophysiology. Despite its global use, KKT is not included in clinical guidelines for neck and back pain due to limited data on its safety and efficacy. This study aims to evaluate the available literature on KKT’s current practice in spinal pain management.

Methods

A systematic literature search of PubMed and Google Scholar identified articles on KKT for cervical and lumbar pain using specific keywords. Eligibility criteria included English-language articles without publication date restrictions, patients over 18 years of age undergoing KKT for neck or lower back pain, any outcome measure, and no restrictions on study design or publication date, with the latest date being June 2024.

Results

The search yielded 219 articles; 5 studies met the inclusion criteria and quality assessment. The studies included three Randomized controlled trials (RCTs) and two case reports. Sample sizes ranged from 1 to 49 participants, focusing on neck and lower back pain. The RCTs were rated as Level 2 evidence, while other studies were rated as lower evidence. A high risk of bias was observed in the included trials, and significant heterogeneity in design and outcomes precluded meta-analysis.

Conclusion

Current evidence on KKT’s efficacy for spinal pain is sparse and inconsistent. While some studies suggest benefits in pain reduction and functional improvement, methodological limitations and small sample sizes undermine generalizability. Further, well-designed studies are needed to evaluate KKT’s efficacy, safety, and costeffectiveness.

Keywords: Khan Kinetic Treatment, KKT, spinal pain, cervical pain, lumbar pain, neuromuscular

[1] Abu Omar AJ, Al Baradie MS, Al Dera H, Vannabouathong C, Bartel L. Management of pain due to cervical multilevel disk bulges and spinal stenosis with a focused vibro-percussion wave treatment: A case report. Clin Case Rep. 2022 Apr;10(4):e05344.

[2] Lo J, Chan L, Flynn S. A Systematic Review of the Incidence, Prevalence, Costs, and Activity and Work Limitations of Amputation, Osteoarthritis, Rheumatoid Arthritis, Back Pain, Multiple Sclerosis, Spinal Cord Injury, Stroke, and Traumatic Brain Injury in the United States: A 2019 Update. Arch Phys Med Rehabil. 2021 Jan;102(1):115–31.

[3] Alshami AM. Prevalence of spinal disorders and their relationships with age and gender. Saudi Med J. 2015 Jun;36(6):725–30.

[4] Bydon M, Alvi MA, Goyal A. Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment. Neurosurg Clin N Am. 2019 Jul;30(3):299–304.

[5] Desmoulin GT, Yasin NI, Chen DW. Spinal mechanisms of pain control. Clin J Pain. 2007 Sep;23(7):576–85.

[6] Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019 Aug;366:l4898.

[7] Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Based Med. 2018 Apr;23(2):60–3.

[8] Jeremy Howick IC. Paul Glasziou, Trish Greenhalgh, Carl Heneghan, Alessandro Liberati, Ivan Moschetti, Bob Phillips, and Hazel Thornton. The 2011 Oxford CEBM Levels of Evidence. 2011. Available from: https://www.cebm.ox.ac.uk/resources/levelsof- evidence/ocebm-levels-of-evidence

[9] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar;372(71):n71.

[10] Desmoulin GT, Reno CR, Hunter CJ. Free axial vibrations at 0 to 200 Hz positively affect extracellular matrix messenger ribonucleic acid expression in bovine nucleus pulposi. Spine. 2010 Jul;35(15):1437–44.

[11] McLain RF, Weinstein JN. Effects of whole body vibration on dorsal root ganglion neurons. Changes in neuronal nuclei. Spine. 1994 Jul;19(13):1455–61.

[12] Papi E, Bull AM, McGregor AH. Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review. Clin Biomech (Bristol). 2018 Jun;55:53–64.

[13] Kreiner DS, Matz P, Bono CM, Cho CH, Easa JE, Ghiselli G, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain. Spine J. 2020 Jul;20(7):998–1024.

[14] Desmoulin G, Yasin N, Chen D. Initial Results Using Khan Kinetic TreatmentTM as a Low Back Pain Treatment Option. J Musculoskeletal Pain. 2007;15(3):91–102.

[15] Alsalamah NM, Bartel L. Management of severe low back pain with a focused vibro-percussion wave treatment: A case report. Clin Case Rep. 2022 Jul;10(7):e6054.

[16] Gillani SN, Ain Q-, Rehman SU, Masood T. Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc. 2020;70(3):394-398.