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Related Experiment Video

Updated: May 21, 2026

Online Repetitive Transcranial Magnetic Stimulation of Dorsomedial and Dorsolateral Prefrontal Cortex in Cognition Decision Making, and Cognitive Dissonance
13:20

Online Repetitive Transcranial Magnetic Stimulation of Dorsomedial and Dorsolateral Prefrontal Cortex in Cognition Decision Making, and Cognitive Dissonance

Published on: December 5, 2025

Centralization and directional preference: a systematic review.

Stephen May1, Alessandro Aina

  • 1Faculty of Health and Wellbeing, Collegiate Cresent Campus, Sheffield Hallam University, Sheffield S10 2BP, UK. s.may@shu.ac.uk

Manual Therapy
|June 15, 2012
PubMed
Summary
This summary is machine-generated.

Centralization and directional preference are key indicators for classifying patients and guiding treatment for back and neck pain. These findings help predict patient outcomes and inform management strategies.

Related Experiment Videos

Last Updated: May 21, 2026

Online Repetitive Transcranial Magnetic Stimulation of Dorsomedial and Dorsolateral Prefrontal Cortex in Cognition Decision Making, and Cognitive Dissonance
13:20

Online Repetitive Transcranial Magnetic Stimulation of Dorsomedial and Dorsolateral Prefrontal Cortex in Cognition Decision Making, and Cognitive Dissonance

Published on: December 5, 2025

Area of Science:

  • Musculoskeletal Rehabilitation
  • Clinical Biomechanics
  • Pain Management

Background:

  • Centralization describes symptom reduction with repeated movements, aiding patient classification and prognosis.
  • Directional preference identifies specific movement patterns that alleviate pain.
  • Understanding these phenomena is crucial for tailoring conservative management strategies for spinal pain.

Purpose of the Study:

  • To systematically review the literature on centralization and directional preference.
  • To report on the prevalence, prognostic validity, reliability, loading strategies, and diagnostic implications of these concepts.
  • To assess their utility in guiding clinical decision-making for spinal conditions.

Main Methods:

  • A systematic literature search was conducted up to June 2011.
  • Multiple study designs were included, encompassing 62 studies (54 on centralization, 8 on directional preference).
  • Data extraction focused on prevalence, prognostic validity, reliability, and treatment implications.

Main Results:

  • Centralization prevalence was 44.4% across 4745 patients, higher in acute (74%) vs. chronic (42%) pain.
  • Directional preference prevalence was 70% in 2368 patients.
  • Twenty-one of 23 studies supported centralization's prognostic validity; 7 of 8 studies indicated centralization and directional preference are useful treatment effect modifiers.

Conclusions:

  • Centralization and directional preference are valuable clinical indicators for patient subgrouping and prognosis in spinal pain.
  • Baseline findings of centralization or directional preference can inform management strategies.
  • Further research is warranted to fully elucidate their diagnostic and prognostic utility.