Directional Preference

Centralisation has been associated with a favorable prognosis. Directional preference is central to the trial protocol. Directional preference is defined as a direction of repeated movement or sustained positioning that produces symptomatic or mechanical improvement. The article notes limited evidence that directional preference modifies treatment effect. Directional preference may include centralisation, in which pain is progressively and permanently abolished from distal to proximal areas. Eligibility requires directional preference identified by clinical examination.