mckenzie

Question 1

what are a few contraindications for mckenzie technique?

Answer 1

serious spinal pathology
cauda equina
cancer
infections
fractures
multilevel neuro deficits
NON MECHANICAL pain: doesn't vary with activity and time

Question 2

what is postural syndrome?

Answer 2

fixed local symptoms w sustained loading

normal periarticular structures

Question 3

what is dysfunction syndrome?

Answer 3

fixed local (except adherent root) symptoms with stretch
adaptively shortened
scarred

Question 4

what is derangement syndrome?

Answer 4

variable intensity and location symptoms and motion loss can rapidly change

Question 5

what are some exam findings that would lead you to suspect postural syndrome?

Answer 5

<30
pain intermittent
no motion loss
no pain with repeated movements
always local: pain produced with static loading at end range

Question 6

what causes dysfunction?

Answer 6

poor posture and frequency of flexion during ADLs leads to loss of extension
secondary complication of surgery, trauma, sciata, or prior derangement (6-8 weeks post-event)
restricted joint mobility
pathology

Question 7

what are exam findings for dysfunction?

Answer 7

motion loss
intermittent pain at end range: NO change in pain location/intensity with repetitions
named for the direction of motion restriction
gradual onset of local symptoms except ANR post trauma/derangement

Question 8

what is an adherent nerve root?

Answer 8

Nerve needs to be stretched (flossing)

Question 9

what are symptoms of an anr?

Answer 9

pain in leg with flexion in standing

not flexion in lying

Question 10

is derangement rapidly reversible?

Answer 10

yes

Question 11

what are 2 types of acute spinal deformities?

Answer 11

lateral shift

reduced lordosis

Question 12

which direction does the disc move in spinal flexion?

Answer 12

posterior

Question 13

which direction does the disc move in spinal flexion?

Answer 13

anterior

Question 14

what are two components of demonstrating a direction preference?

Answer 14

• movement in one direction reduces, centralizes or abolishes symptoms
• movement in opposite direction increases or peripheralises symptoms

Question 15

what are three components of a reducible derangement in disc herniation?

Answer 15

contained
intact hydrostatic mechanism
typically demonstrates a directional preference

Question 16

what are four components of a irreducible derangement?

Answer 16

same history as reducible
no loading strategy causes a LASTING change in symptoms
annulus incompetent or ruptured
hydrostatic mechanism not intact

Question 17

what are the four stages of disc herniations in order of severity?

Answer 17

intra-discal displacement
protrusion
extrusion
sequestration

Question 18

what does it mean for pain to centralize?

Answer 18

change in location of most distal/lateral symptom proximally or toward midline in response to loading strategies

Question 19

can proximal symptoms increase as pain centralize?

Answer 19

yes

Question 20

what are 8 exam findings for derangement?

Answer 20

• general 20-55
• pain constant or intermittent
• pain local or referred into leg
• pain during motion or at end range
• sudden or gradual onset
• loss of motion
• centralization/peripheralization
• directional preference

Question 21

what is meant by directional preference?

Answer 21

pain located in the most distal body part decreases in intensity, abolishes, or centralizes and/or whether subjects have improved ROM in response to repeated movement or positional loading strategies

Question 22

what are three ways of naming derangements?

Answer 22

central/symmetrical
unilateral/asymmetric above the knee
unilateral/asymmetrical below the knee

Question 23

how is a directional preference in derangement named?

Answer 23

direction of movement causing symptoms to centralize, abolish or REDUCE in intensity

Question 24

what are two components of the “extension principle” in central symmetrical derangement?

Answer 24

worse w flexion, better w extension

if kyphotic deformity, will require unloading and longer time to heal

Question 25

what are three components of the “flexion principle” in central symmetrical derangement?

Answer 25

worse with walking and standing
obstruction to bending
better w sitting

Question 26

what is the progression for anr testing? how long might pain be present as an indicator?

Answer 26

longer than 12 weeks

-pain w FIS, no pain FIL, no change w reps

Question 27

what directions should the extension principle be used in derangement vs. dysfunction?

Answer 27

posterior derangement

extension dysfunction to reproduce local pain to stretch tissue

Question 28

what directions should the flexion principle be used for in terms and derangement vs. dysfunction?

Answer 28

anterior derangement
extension dysfunction to stretch
use for recovery of function after posterior derangement

Question 29

what are dosing guidelines for dysfunction?

Answer 29

10 reps every 2-3 hours
discomfort felt locally at end range during the exercise and is abolished w return to neutral
new pains in thoracic/shoulder areas due to new exercise
4-6 week recovery

Question 30

what are dosing guidelines for derangement?

Answer 30

10x every 2-3 hours of if symptoms increase
centralize/decrease/abolish pain
may cause temporary new pain