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  • New in the Literature: Classification Methods for Lumbar Impairments (J Man Manip Ther. 2010;18:197-204.)

    The majority of patients with lumbar impairments who are classified based on initial clinical presentation by manipulation and stabilization clinical prediction rules (CPRs) also are classified as derangements whose symptoms centralized, say authors of an article published in Journal of Manual & Manipulative Therapy. Manipulation and stabilization CPRs may not represent a mutually exclusive treatment subgroup, but may include patients who can be initially treated using a different classification method, they add.  

    Eight physical therapists practicing in 8 diverse clinical settings classified patients typically referred to rehabilitation by McKenzie syndromes (McK) (eg, derangement, dysfunction, and posture, pain pattern classification (eg, centralization [CEN], not centralization [Non CEN], and not classified [NC]), manipulation CPR (positive, negative), and stabilization CPR (positive, negative). Prevalence rates were calculated for each classification category by McK, pain pattern classifications (PPCs), and manipulation and stabilization CPRs. Prevalence rates for McK and PPCs were calculated for each CPR category separately.

    Data from 628 adults (mean age: 52±17 years, 56% female) were analyzed. Prevalence rates were:

    • McK-- derangement 67%, dysfunction 5%, posture 0%, other 28%
    • PPC -- CEN 43%, Non CEN 39%, NC 18%
    • manipulation CPR -- positive 13%
    • stabilization CPR -- positive 7%

    For patients positive for manipulation CPR (n = 79), prevalence rates for derangement were 89% and CEN 68%. For patients positive for stabilization CPR (n = 41), prevalence rates for derangement were 83% and CEN 80%.


    • This is important information for all of us. If the patient can be instructed to self-treat not only are we decreasing the risk of injury, but we are allowing the patient to discover they can successfully manage their pain on their own and avoid debilitating recurrences!

      Posted by Kay Scanlon on 1/29/2012 7:35 AM

    • Did anyone see the full-text of this article? I'm a little confused on what the conclusion would be. Is it suggesting that Mackenzie would be a superior way of classifying/treating these patients rather than manipulation/stabilization cpr's?

      Posted by Rachael on 1/29/2012 11:05 PM

    • I've read this article about over a year ago and was confused as heck. However, after reading a portion of the McK book, I somewhat understand what is being said here. And yes, to my understanding, you are correct, they are suggesting that McK classification is better than the other ones...including McK treatment. McK is all about teaching the patient how to care for him/herself and so far, there is not any better treatment than it...research has not proven so. This article does a very poor job though, it is not clear at all and the data does not help...

      Posted by Jean Dornevil -> AOX`AN on 7/21/2014 8:24 AM

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