Makenzie method

Question 1

assessment

Answer 1

hisotry and symptom presentation

idenfity patterns of movement

Question 2

what are the patterns of movment?

Answer 2

applied mechanical forces
pain response to monitor changes in motion/function
idenfity the underlying cause and sub-group patients into syndromes
syndrome dictates the appropriate treatment

Question 3

derangement

Answer 3

loading stretegies centralize or make symptoms better

(anatomical disruption or displacement within the motion segment

Question 4

dysfunction

Answer 4

pain only produced at limited end range (end range stress of shorted strucutres

Question 5

postural

Answer 5

pain only on static loading, no effect of repeated movements

end range stress of normal structures

Question 6

other

Answer 6

not consistent with the 3 makenzie syndromes

Question 7

what are the other things that could be wrong if it is not derangement, dysfunction, postural

Answer 7

chronic pain syndrome
inflammatory
mechanically inconclusive
mechanically unresponsive radiculopathy
post surgery
SI
spinal stenosis
trauma

Question 8

postural syndrome treatment

Answer 8

MC: lower cervical and lumbar flexion
treatement: patient education
avoid the posture (remain in safe neutral zone)
overcorrect the posture (extreme lordosis and head reaction)

Question 9

dysfucntion syndrome treatment

Answer 9

motto: no pain, no gain
stretch the shortened tissue
load tissue at the shortened end range
looking for gains in ROM

Question 10

centralization

Answer 10

process inwhich distal symptoms that began in the spine are abolished in a distal to proximal direction and remain better over time until all pain is abolished

Question 11

centralizing

Answer 11

during the application strategy distal symptoms are being abolished

Question 12

centralized

Answer 12

after the application of the loading strategy all of the distal symptoms have been abolished and only back pain remains

Question 13

centralization characteristics

Answer 13

only in derangement syndrome
usually rapid and always lasting change
reliably assessed
occurs in repsonse to loading strategies

Question 14

derangement syndrome

Answer 14

derangement of intervertebral disc
obstructed end ROM in one direction
symptoms may vary depending on direction of loading
treatemtn is loading to pursue centralization

Question 15

centralization vs peripheralization

Answer 15

centralization- symptoms retreat toward the center of the body
peripheralization- symptoms move away from the center of the body into the extremities

Question 16

posterior derangemetn

Answer 16

kyphotic lean/flexion antalgia
good flexion ROM
decreased extension ROM
treat with extension (increase ROM)

Question 17

anterior derangemetn

Answer 17

lordotic lean/increased lordosis

flexion loading is therapeutic (increase ROM, compress discal material)

Question 18

relevant posterolateral derangement

Answer 18

extreme coronal antalgia (acute torticollis or lumbar scoliosis)
most posterolateral derangement respond to sagittal plane loading and don’t require coronal plane movements
those that don’t respond are “relevant” because lateral motion is required

Question 19

relevant posterolateral derangement

Answer 19

present with lateral lean (acute torticollis, acute scoliosis, flexion ROM is normal, extension is impeded)

Question 20

treatment for relevant posterolateral derangement

Answer 20

lateral glide loading of disc

followed by extension loading