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McKenzie's idea was that the nucleus is dynamic to some degree and that repeated movements can change the dynamics of the nucleus, altering the symptoms of the patient in a rational and consistent fashion. He developed the idea of centralisation and peripheralisation to describe the symptom changes. In centralisation the symptoms of the patient reduced or disappeared in a farther part of the pain distribution and concentrated more towards the low back to a degree. In peripheralisation the reverse occurred with symptoms perhaps spreading from the low back to the buttock or down the leg.Centralisation implies improvement in the disc mechanics while peripheralisation implies a worsening and the physiotherapist will test a patient using a variety of repeated movements in particular directions to see what effect this has on the symptoms. Commonly the patient will display a directional preference, in other words a particular movement which, when repeated, improves their symptoms and will likely be the basis their treatment. Sitting and bending over both involved repeated or sustained flexion and it is to correct these problems that much therapy is aimed.Article Source: http://EzineArticles.com/4520121
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