Table 1

Five distinct directional patterns of movement control impairment [72] (personal communication)

Direction of movement control impairment

Pain aggravation

Pain relief

Movement control deficit


Sustained flexion of lumbar spine, e.g. when sitting

Extension of lumbar spine, e.g. when standing and walking

Difficulty controlling lordosis in sitting and flexed positions

Active Extension

Sustained extension of lumbar spine

Flexion of lumbar spine, relaxing in flexed posture. Breathing exercises

Difficulty flexing when sitting or breathing with diaphragm

Passive extension

Extension of lumbar spine, e.g. when standing or walking slowly

Flexion of lumbar spine, e.g. while sitting

Tilting pelvis posteriorly

Frontal pain control

unilateral pain in unilateral loading and sidebending

Control pelvis and thorax in frontal plain

Maintain symmetric posture

Multidirectional pattern


Changing lumbar spine position

Difficulty assuming neutral lordotic spinal positions

Description: Specification of main symptoms and signs to classify the direction of movement control impairment

Saner et al. BMC Musculoskeletal Disorders 2011 12:207   doi:10.1186/1471-2474-12-207

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