Effect of Directional Preference Exercises in Lumbar Derangement Syndrome

The McKenzie method of mechanical diagnosis and therapy is one of the most common system used in the diagnosis and management of spinal pain conditions. Derangement is an MDT classification which is defined as an anatomical disturbance in the normal resting position of the joint, and mckenzie proposed that repeated movements could be applied to reduce internal joint displacement and rapidly reduce derangement symptoms.

The purpose of this study was to observe the symptomatic and mechanical changes associated with specific directional preference exercises in lumbar derangement

case series

3 patients with pain in low back and or buttocks with or without radicular pain in lower extremity, of age group 18–60 years and classified as lumbar derangement were included in this study. Each patient underwent mechanical assessment and was treated with repeated movements based on their directional preference. Patients were asked to report twice a week. Follow up assessment was done after 1week, 2weeks and 8weeks. Pain was measured by Numerical Pain rating Scale (NPRS), Functional disability by Modified Oswestry Disability Index (MODI) and Lumbar Flexion and Extension Range of Motion by measuring inch tape were the outcome measures.

All patients demonstrated rapid and clinically improvement in baseline measures.

Clinically significant change results in mean NPRS from 7 to 1, mean MODI from 50% to 10% and mean lumbar range of flexion 5.1 to 6.33 cm and range of extension from 0.8. to 1.26 cm

Our findings suggest that directional preference exercises guided by patient's response may be an effective treatment approach for LBP