The centralization phenomenon of spinal symptoms—a systematic review

Prevalence of classification methods for patients with lumbar impairments using the McKenzie syndromes, pain pattern, manipulation, and stabilization clinical prediction rules

“…Centralization is characterized by spinal pain and referred spinal symptoms that are progressively abolished in a distal-to-proximal direction in response to therapeutic movement and positioning strategies. 5,10 Although the validity for classifying patients into one of the three MDT mechanical subgroups has not been determined, numerous research studies support CEN as an important prognostic factor and classification category for identifying patients who respond favorably from specific CEN-based interventions. [10][11][12][13][14][15][16][17][18][19][20] Classification by patient response criteria including CEN and directional preference for directing treatment have been frequently recommended by clinicians and researchers.…”

“…5,10 Although the validity for classifying patients into one of the three MDT mechanical subgroups has not been determined, numerous research studies support CEN as an important prognostic factor and classification category for identifying patients who respond favorably from specific CEN-based interventions. [10][11][12][13][14][15][16][17][18][19][20] Classification by patient response criteria including CEN and directional preference for directing treatment have been frequently recommended by clinicians and researchers. 11,[13][14][15][21][22][23][24][25][26][27][28][29] Similar to the three McKenzie syndromes, a substantial proportion of patients (estimates range between 31 and 87%) seen in physical therapy clinics for treatment of low back pain can be classified into a CEN category at intake.…”

“…11,[13][14][15][21][22][23][24][25][26][27][28][29] Similar to the three McKenzie syndromes, a substantial proportion of patients (estimates range between 31 and 87%) seen in physical therapy clinics for treatment of low back pain can be classified into a CEN category at intake. 10 The TBC system is another common approach used by physical therapists for classifying patients based on a standardized physical evaluation process. 6 Patients are classified into three stages based on condition severity, i.e., stage 1 or the acute stage where therapy goal is symptomatic relief; stage 2 or the subacute stage where return to normal function is a priority; and stage 3 or the advanced rehabilitation stage for patients requiring high physical demands and conditioning to perform their usual work or activities of daily living.…”

Effects of Electromagnetic Diathermy in Conjunction with Nerve Mobilization in the Management of Lower Back Pain

“…Nerve mobilization would load not only the nervous system but also non-neural structures 20) . Centralization of symptoms in patients with back pain indicates a favorable prognosis 21,22) , and is used to guide treatment in patients with back pain and lower extremity symptoms. In this study, nerve mobilization in conjunction with electromagnetic diathermy was more effective at the centralization of symptoms and strength, than was nerve mobilization alone.…”

Low Back Pain Response to Pelvic Tilt Position: An Observational Study of Chiropractic Patients

“…2 Posterior tilting of the pelvis has been recommended as an exercise for relief of LBP since at least as far back as the 1980s 3,4 and can still occasionally be found in patient education literature and Internet sites. Nor is the concept unique to this exercise; there are many published examples of directional preference-the identification of which positions and movement patterns relieve or aggravate pain-for lumbar flexion, as well as for extension and lateral bending [5][6][7][8][9][10][11] -and use of that information for therapeutic decisions.…”