McKenzie Approach

Question 1

The McKenzie method is AKA

Answer 1

Mechanical diagnosis and Therapy

Question 2

McKenzie definition

Answer 2

Philosophy of active pt involvement and education
Approach to examination, intervention, and prevention
Used throughout the world for back, neck, and extremities

Question 3

Peripheralization

Answer 3

pain moves laterally away from the center of the spine and/or down the extremity

Question 4

Centralization

Answer 4

symptoms move proximally up the extremity and toward the center of the spine
Even if the pain becomes more intense, it is centralizing

Question 5

Centralization phenomenon

Answer 5

Radiating symptoms originating from the spine move proximally toward the midline of the spine as the result of repeated motion or adoption of certain positions

Question 6

Centralization phenomenon - Movements that promote centralization can be used to

Answer 6

abolish radiating symptoms

Localized central pain adjacent to the spine may increase

Question 7

Biomechanics of IVD - 1st stage of protrusion

Answer 7

displacement sufficient only to cause distortion of nociceptors in annulus and or PLL

Question 8

Biomechanics of IVD - greater pressure on nerve root =

Answer 8

more distal sx are felt

Question 9

Biomechanics of IVD - with annular wall still compentent (first two stages) what can happen

Answer 9

posterolateral protrusions may be reversible using sagittal extension forces

Question 10

Contraindications

Answer 10

Fractures (suspected or diagnosed)
Metastases
Cauda equina
Osteoporosis 
Progressive neurological disease
Inflammatory joint disease (RA, AS, Reiter's syndrome)

Question 11

McKenzie classification - mechanical diagnosis includes

Answer 11

Postural syndrome
Dysfunction syndrome
Derangement syndrome

Question 12

Postural syndrome

Answer 12

Intermittent pain only with STATIC prolonged loading of NORMAL tissues
Mechanical deformation of peri-articular soft tissue as a result of postural stress

Question 13

Postural syndrome - what changes pain

Answer 13

Pain is decreased with moving out of aggravating posture and repeated movement

Question 14

Intervention for postural syndrome is

Answer 14

Postural education/ergonomics

Question 15

Dysfunction syndrome

Answer 15

Adaptive shortening of mechanically deformed tissues

Question 16

Dysfunction syndrome - cause

Answer 16

Past trauma, pain, poor posture, degeneration can be cause

Fibrous repair of above leading to abnormal tissue with restricted and painful end range

Question 17

Dysfunction syndrome - description of s/s

Answer 17

Intermittent pain
Articular dysfunction with pain at limited end range
Pain as tissue is stressed through posture or activity
End range pain stops on cessation of loading
The pain does not peripheralize or worsen with repeated movement

Question 18

Dysfunction syndrome - intervention

Answer 18

Treat with the movement that produces the pain!!!

Goal is to stretch the tightened muscles and connective tissue

Question 19

Derangement syndrome

Answer 19

MOST COMMON
Disc mechanics
Certain loading pattern - peripheralization of s/s, opposite loading pattern centralizes the s/s

Question 20

Derangement syndrome - repeated movement in the direction that increase accumulation of nuclear material results in

Answer 20

Progressively increasing derangement/peripheralization of pain

Question 21

Derangement syndrome - loading strategies ex for lumbar - if inc pain with sitting (flex)

Answer 21

Dec pain with walking (ext)

Question 22

Derangement syndrome - loading strategy ex for cervical - if inc peripheralization with protrusion

Answer 22

centralization with repeated retrusion

Question 23

Derangement syndrome intervention

Answer 23

Treat with movement that relieves pain to decrease mechanical deformation of the derangement