Directional preference and centralization are two phenomena described in the “derangement” 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.
The 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.
MASSIVELY IMPROVE YOUR KNOWLEDGE ABOUT LOW BACK PAIN FOR FREE
In the case of directional preference and/or centralization, a patient’s symptoms can often be modified by performing repeated movements in the preferred direction.
In 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:
What others say about "Orthopedic Physiotutherapy of the Spine" Online Course
Orthopedic Physiotherapy of the Spine Really a well done course, using the modern ways of teaching. Compliments! Sometimes for me you entered too much into details instead of touching more important chapters of Spine treatment like techniques for the treatment of muscles and fascias
Orthopedic Physiotherapy of the Spine EXCELLENT COURSE HIGHLY RECOMMEND
As a newly graduated physiotherapist i highly recommend this course just to know you are on the right track with your patients. the information presented is very clear and easy to follow as well as the great physiotherapy style videos. It makes learning actually fun , thanks guys for all your hard work. Well deserved.
Orthopedic Physiotherapy of the Spine During the corona crisis, I booked many online courses and webinars, but none were as entertaining and well thought out as PhysioTutors’ courses.
All units are well summarized, meaningfully broken down and easy to understand.
I am looking forward to the other courses.
Many greetings from Germany.
Orthopedic Physiotherapy of the Spine VERY INFORMATIVE AND UPDATED
for anyone who is lost in handling spine cases, this course is very helpful.
Orthopedic Physiotherapy of the Spine HIGHLY METHODICAL, WITH PLENTY OF SCIENTIFIC REFERENCE
Clear, structured and well researched course concerning most common pathologies of the spinal complex.
Plenty of informative modules, with detailed video-analysis.
If you’re looking for a course to study in your own time, with enough depth and scientific background, then you’ve found a very good one here.
Bang for buck, a great course.
Orthopedic Physiotherapy of the Spine After finishing the Orthopedic course for Lower & Upper limbs, I was looking forward to begin this Spine specific course.
Really good overview about all spine pathologies from epidemiology to diagnosis & treatment which made me more confident to care for my future patients.
ANOTHER GREAT COURSE !
The courses are well detailed with lot of informations and videos.
For me these 2 courses are must to see to learn and update knowledge for most common pathologies in Physiotherapy.
Orthopedic Physiotherapy of the Spine This is a very interesting course !
We can find many informations about the main pathologies and their differential diagnosis and about objective and subjective exam. Videos are clear and well designed.
It’s a very well course for these who wish complete their Orthopedic Manual Therapy curriculum.
A French Physio’
This content is for members
Create your free account to gain access to this exclusive content and more!