{"id":8268,"date":"2021-11-09T17:57:54","date_gmt":"2021-11-09T16:57:54","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&amp;p=8268"},"modified":"2021-11-09T17:57:54","modified_gmt":"2021-11-09T16:57:54","slug":"direction-specific-exercises","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/direction-specific-exercises\/","title":{"rendered":"Direction-specific exercises"},"featured_media":8460,"template":"","class_list":["post-8268","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":8460,"background_image_alt_text":""},"heading":"Direction-specific Exercises for low back pain","subheading":"Acute low back pain","content_editor":"","button_type":"url","button_label":"Check our shop","button_style":"button-five","button_internal_link":null,"button_anchor":"","button_url":"https:\/\/study.physiotutors.com\/course\/orthopedic-physiotherapy-of-the-spine\/","button_file":null,"label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Online Course","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":null},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>Learn<\/h4>"},"column_right":{"content_editor":"<h6><strong>Direction-specific exercises for low back pain<\/strong><\/h2>\nDirectional preference and centralization are two phenomena described in the \u201cderangement\u201d classification of the McKenzie concept. Directional preference means that repeated movements in one direction, so either flexion, extension, or lateral flexion of the lumbar or cervical spine are able to progressively abolish symptoms and or increase lumbar range of motion. A systematic review of May et al. In the year 2012 found the 70% of patients did exhibit such a directional preference.\n\nThe McKenzie concepts also talk about the phenomenon of centralization. Centralization is a symptom response to repeated movements that is characterized by the abolition of spinal pain and referred spinal pain symptoms in a distal-to-proximal direction. According to the review of May, 44% of patients presented with centralization. The prevalence was higher among younger patients and in acute low back pain (74%) in comparison with patients above 65 or if back pain was persistent (42%). The presence of centralization was also a useful treatment effect modifier in 7 out of 8 included studies.\n\n[cta]\n\nIn the case of directional preference and\/or centralization, a patient\u2019s symptoms can often be modified by performing repeated movements in the preferred direction.\n\nIn the following, we will show you a couple of examples for the lumbar spine that we find useful in practice for patients with acute low back pain with or without radiculopathy. Be aware that this is absolutely no strict application of the McKenzie concept whatsoever:\n<div class=\"embed-container\">\n\n[embed]https:\/\/www.youtube.com\/watch?v=ShM14BoX2WE[\/embed]\n\n<\/div>\n<h6><\/h3>\n<h6><\/h3>\n<h6><strong>References:<\/strong><\/h3>\nJarod Hall: <a href=\"https:\/\/www.youtube.com\/watch?v=OmVla0VdunA\" target=\"_blank\" rel=\"noopener\">https:\/\/www.youtube.com\/watch?v=OmVla0VdunA<\/a>\n\n<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22695365\" target=\"_blank\" rel=\"noopener\">May S, Aina A. Centralization and directional preference: a systematic review. Manual therapy. 2012 Dec 1;17(6):497-506.<\/a>\n\n<a href=\"http:\/\/ncbi.nlm.nih.gov\/pmc\/articles\/PMC2700497\/\" target=\"_blank\" rel=\"noopener\">Laslett M. Manual correction of an acute lumbar lateral shift: maintenance of correction and rehabilitation: a case report with video. Journal of Manual &amp; Manipulative Therapy. 2009 Apr 1;17(2):78-85.<\/a>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>References<\/h4>"},"column_right":{"content_editor":"Jarod Hall: <a href=\"https:\/\/www.youtube.com\/watch?v=OmVla0VdunA\" target=\"_blank\" rel=\"noopener\">https:\/\/www.youtube.com\/watch?v=OmVla0VdunA<\/a>\n\n<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22695365\" target=\"_blank\" rel=\"noopener\">May S, Aina A. Centralization and directional preference: a systematic review. Manual therapy. 2012 Dec 1;17(6):497-506.<\/a>\n\n<a href=\"http:\/\/ncbi.nlm.nih.gov\/pmc\/articles\/PMC2700497\/\" target=\"_blank\" rel=\"noopener\">Laslett M. Manual correction of an acute lumbar lateral shift: maintenance of correction and rehabilitation: a case report with video. Journal of Manual &amp; Manipulative Therapy. 2009 Apr 1;17(2):78-85.<\/a>"}},{"acf_fc_layout":"cta-image-v2","layout":"","background":"transparent","heading":"","content_editor":"<p class=\"subheading\">Like what you\u2019re learning?<\/p>\n<p class=\"heading-two\">BUY THE FULL PHYSIOTUTORS <strong>ASSESSMENT BOOK<\/strong><\/p>\n\n<ul>\n \t<li>600+ Pages e-Book<\/li>\n \t<li>Interactive Content (Direct Video Demonstration, PubMed articles)<\/li>\n \t<li>Statistical Values for all Special Tests from the latest research<\/li>\n \t<li>Available in \ud83c\uddec\ud83c\udde7 \ud83c\udde9\ud83c\uddea \ud83c\uddeb\ud83c\uddf7 \ud83c\uddea\ud83c\uddf8 \ud83c\uddee\ud83c\uddf9 \ud83c\uddf5\ud83c\uddf9 \ud83c\uddf9\ud83c\uddf7<\/li>\n \t<li>And much more!<\/li>\n<\/ul>","button_type":"internal_link","button_label":"Check out our 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