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Chapter Objectives

At the conclusion of this chapter, the reader will be able to:

  • Briefly describe the confluence of factors leading to the development of the Mechanical Diagnosis and Therapy (MDT) approach.

  • Discuss the philosophical underpinnings upon which the MDT approach is based.

  • Describe, in detail, the three primary syndromes used to classify patients within the MDT approach.

  • Discuss the concept of centralization and peripheralization and the implications of these concepts on prognosis and pathology.

  • Describe the primary methods that may be used to differentially classify patients into one of the three primary syndromes.

  • Understand the criteria required to determine an individual's principle of intervention.

  • Identify the criteria needed to determine the presence of a lateral shift.

  • Articulate the manner in which forces are progressed within this approach and when manual interventions may be applied.

  • Describe and demonstrate the progression of intervention for each of the syndromes.

  • Identify the key features that differentiate this approach from that of others.


Personal Background

Robin McKenzie was born in Auckland, New Zealand, in 1931. He graduated from the School of Physiotherapy of New Zealand in 1952 and began a private practice in Wellington, where he specialized in the treatment of spinal disorders. His insight and study of mechanical spinal disorders has made Robin McKenzie a pioneer in the classification and treatment of these conditions. In addition to publishing in the New Zealand Medical Journal, among others, he has authored five books: Treat Your Own Back; Treat Your Own Neck; The Lumbar Spine: Mechanical Diagnosis and Therapy; The Cervical and Thoracic Spine: Mechanical Diagnosis and Therapy; and, in collaboration with Stephen May, Mechanical Diagnosis and Therapy of the Human Extremities.

Among his many honors, Robin McKenzie was made an Honorary Life Member of the American Physical Therapy Association (APTA) for "distinguished and meritorious service to the art and science of physical therapy and to the welfare of mankind." Additionally, he was elected to membership in the International Society for the Study of the Lumbar Spine, and he is a Fellow of the American Back Society, an Honorary Fellow of the New Zealand Society of Physiotherapists, and an Honorary Fellow of the Chartered Society of Physiotherapists in the United Kingdom. In the 1990 Queen's Birthday Honours, he was made an Officer of the Most Excellent Order of the British Empire, and in 2000 Her Majesty the Queen appointed Robin McKenzie as a Companion of the New Zealand Order of Merit. McKenzie received an Honorary Doctorate from the Russian Academy of Medical Sciences in 1993. In 2004, McKenzie was named the most influential and distinguished physical therapist in the field of orthopaedic physical therapy by a random sampling of 320 physical therapists in the Orthopaedic Section of the APTA.

Development of the Mechanical Diagnosis and Therapy Approach


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