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Classification by pain pattern for patients with cervical spine radiculopathy
Richard Yarznbowicz1, Matt Wlodarski2, Jonathan Dolutan2
1DPT, Center for Orthopedic and Sports Physical Therapy , Tallahassee, FL, USA.
The Journal of Manual & Manipulative Therapy
|May 3, 2019
Summary
Mechanical Diagnosis and Therapy (MDT) classification, including Centralization (CEN), improved disability for Cervical Spine Radiculopathy (CSR) patients. While CEN showed greater improvements, neither CEN nor Non-CEN significantly impacted pain intensity.
Area of Science:
- Orthopedics
- Physical Therapy
- Spine Care
Background:
- Cervical Spine Radiculopathy (CSR) presents diagnostic challenges.
- Mechanical Diagnosis and Therapy (MDT) offers a classification-based approach.
- Understanding Centralization (CEN) and Non-CEN prevalence is crucial for targeted treatment.
Purpose of the Study:
- To determine the prevalence of MDT classifications, CEN, and Non-CEN in CSR patients.
- To examine the association between CEN/Non-CEN classification and clinical outcomes.
- To evaluate the effectiveness of MDT in managing CSR.
Main Methods:
- Prospective observational cohort study.
- Inclusion criteria for CSR based on physical examination.
- Data collection on MDT classifications, CEN/Non-CEN status, and clinical outcomes at follow-up.
Main Results:
- 6% of 680 patients met CSR inclusion criteria; 19 completed follow-up.
- 79% classified as Reducible Derangement; 21% other classifications.
- 36.8% CEN, 47.4% Non-CEN.
- All MDT-treated patients improved in disability, not pain intensity.
- CEN group showed greatest outcome changes, earlier discharge, and fewer visits, though not statistically significant vs. Non-CEN.
Conclusions:
- MDT classification and treatment significantly improve disability in CSR patients.
- While pain intensity did not significantly change, disability improvements support MDT use.
- MDT offers a viable treatment strategy for CSR, potentially reducing healthcare utilization.
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