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 LECTURE NO 1

CERVICAL SPINE
McKenzie's Approach

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McKenzie Approach

Mechanical Diagnosis and Therapy (MDT)

“My Patients taught me all I
know”

Robin Anthony McKenzie

 Cervical Spine

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 Cervical Spine

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 Couple Movements
Cervical Spine

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Cervical Spine - Prevalence

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prevalence of neck pain among undergraduate
students of Riphah International University.
• Study design:
• Cross-Sectional survey
• Sample size:
• 120 students included.

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• Duration:
• 6 months study duration from September 2014 to February
2015
• Participants:
• Students of programs DPT, MBBS and D-pharm of RIU
• Inclusion criteria:
• Students (both male and female) of undergraduate programs
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(DPT, MBBS and D-pharm) of Riphah International University.
prevalence of neck pain among undergraduate
students of Riphah International University.

Result
• results showed 12% prevalence in undergraduate
students of RIU which is very low as compared to

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previous studies
• 87.5% students complained for neck pain due to
laptop or any other digital product use
• (70%) of students keep their neck in flexed
position while studying
• Majority of DPT (46%) and MBBS (23%) students 10
had restricted work activities due to neck pain
Cervical Spine - Prevalence

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 Cervical Spine
Treatment Effectiveness

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Cervical Spine
Pain Types

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 Cervical Spine

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 Cervical Spine

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 Cervical Spine

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 Cervical Spine
Neurological examination

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Cervical Spine

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 Cervical Spine
Neurological examination

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 Cervical Spine
Neurological examination

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 Cervical Spine
Examination of the movements

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 Cervical Spine
Examination of the movements

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 Cervical Spine
Examination of the movements

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 Cervical Spine
Examination of the movements

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 Cervical Spine
Examination of the movements

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Cervical Spine
• Factors that affect the ROM
• Age
• Degenerative Changes

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• Posture
• Neck pain

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Cervical Spine
• Factors that affect the ROM
• Women are greater ROM then
Male

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• Passive motion is greater then
active
• In the relax slump posture there is
less 10 degree extension. 28
Cervical Spine
• Effect of posture on cervical spine
• In slumped posture the head is
protruded.

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• Looking forward make upper
cervical spine in extension.

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 Cervical Spine
Sitting posture and its effects
on pain

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Cervical Spine
• Effects of movement on structures

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Cervical Spine
• Effects of movement on structures

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Cervical Spine
• Effects of movement on structures

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Cervical Spine
• Effects of movement on structures

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Cervical Spine
• Effects of movement on structures

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Mechanical Therapy of
the cervical spine
 Mechanical Therapy of the
cervical spine
Application of the procedure

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In sitting

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In sitting
With Patient
Overpressure

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In sitting
Clinician
Overpressure

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In sitting
Mobilization

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In standing

Same As Sitting

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In supine
with pillow support

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In supine
without pillow support

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In supine
with Clinician
Over Pressure

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In supine
Mobilization

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In Prone

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In Prone
With Patient
overpressure

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In Prone
With Clinician
overpressure

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Retraction

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In Prone
Mobilization

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Procedure-2

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Retraction and Extension
In Sitting

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Procedure-2

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Retraction and Extension with Rotation
In Sitting

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Procedure-2

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Retraction and Extension with Rotation
In Supine

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Procedure-2

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Retraction and Extension
In Prone

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Procedure-2

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Retraction and Extension
In Prone
With
Patient
overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE
Procedure-2

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Retraction and Extension with rotation
Clinician
Traction
In
supine
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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
EXTENSION PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure

LATERAL PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”

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In Sitting

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”

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In Sitting
With
Patient
Overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”

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In Sitting
With
Clinician
Overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”

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In Sitting
With
Mobilization

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”

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In Supine

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”

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In Supine
With
Patient
Overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”
In Supine
With
Clinician
Overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-4 “Lateral Flexion”
In Supine
With
Mobilization

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Sitting

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Sitting
With
Patient
overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Sitting
With
Clinician
overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Sitting
With
Mobilization

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Supine

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Supine
With
Patient
overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Supine
With
Clinician
overpressure

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 Mechanical Therapy of the
cervical spine
Application of the procedure
LATERAL PRINCIPLE
Procedure-5 “Rotation”
In Supine
With
Mobilization

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 Mechanical Therapy of the
cervical spine
Application of the procedure

FLEXION PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
FLEXION PRINCIPLE

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 Mechanical Therapy of the
cervical spine
Application of the procedure
FLEXION PRINCIPLE
Procedure-6 “Flexion”

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In Sitting

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 Mechanical Therapy of the
cervical spine
Application of the procedure
FLEXION PRINCIPLE
Procedure-6 “Flexion”
In Sitting
With
Patient
Overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
FLEXION PRINCIPLE
Procedure-6 “Flexion”

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In Supine

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 Mechanical Therapy of the
cervical spine
Application of the procedure
FLEXION PRINCIPLE
Procedure-6 “Flexion”
In Supine
With
Patient
Overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
FLEXION PRINCIPLE
Procedure-6 “Flexion”
In Supine
With
Clinician
Overpressure
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 Mechanical Therapy of the
cervical spine
Application of the procedure
FLEXION PRINCIPLE
Procedure-6 “Flexion”
In Supine
With
Mobilization

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REFRENCES
1. Dreisinger, PhD, Thomas E. "McKenzie Therapy
for Mechanical Low Back Pain." Spine-Health .
N.p., 8 Mar. 2007. Google . Web. 1 Mar. 2013.
2. http://www.spine-health.com/wellness/

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exercise/mckenzie- therapy-mechanical-low-
back-pain>.
3. The McKenzie Institute®, USA. 2013 The
McKenzie Institute International., 2013. Web. 1
Mar. 2013.
<http://www.mckenziemdt.org/method.cfm>. 92