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%.