although this systematic review showed mixed results, some evidence was found supporting the effectiveness of dpm when applied to participants with a dp, particularly at short-term and intermediate-term follow-ups. background providing specific treatment based on symptom response for people with low back pain (lbp) and a directional preference (dp) is a widely used treatment approach. the efficacy of treatment using the principles of directional preference management (dpm) for lbp is unclear. objective the purpose of this study was to determine the efficacy of treatment using the principles of dpm for people with lbp and a dp. methods computer databases were searched for randomized controlled trials (rcts) published in english up to january 2010. only rcts investigating dpm for people with lbp and a dp were included. outcomes for pain, back specific function, and work participation were extracted. results six rcts were included in this review. five were considered high quality. clinical heterogeneity of the included trials prevented meta-analysis. grade quality assessment revealed mixed results; however, moderate evidence was identified that dpm was significantly more effective than a number of comparison treatments for pain, function, and work participation at short-term, intermediate-term, and long-term follow-ups. no trials found that dpm was significantly less effective than comparison treatments. conclusions although this systematic review showed mixed results, some evidence was found supporting the effectiveness of dpm when applied to participants with a dp, particularly at short-term and intermediate-term follow-ups. further high-quality rcts are warranted to evaluate the effect of dpm applied to people with lbp and a dp.
the kdt neural-flex allows prone extension directional preference positioning which takes advantage of migration patterns in posterior discs
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low back pain is usually nonspecific or mechanical. mechanical low back pain arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues. clinical clues, or red flags, may help identify cases of nonmechanical low back pain and prompt further evaluation or imaging. red flags include progressive motor or sensory loss, new urinary retention or overflow incontinence, history of cancer, recent invasive spinal procedure, and significant trauma relative to age. imaging on initial presentation should be reserved for when there is suspicion for cauda equina syndrome, malignancy, fracture, or infection. plain radiography of the lumbar spine is appropriate to assess for fracture and bony abnormality, whereas magnetic resonance imaging is better for identifying the source of neurologic or soft tissue abnormalities. there are multiple treatment modalities for mechanical low back pain, but strong evidence of benefit is often lacking. moderate evidence supports the use of nonsteroidal anti-inflammatory drugs, opioids, and topiramate in the short-term treatment of mechanical low back pain. there is little or no evidence of benefit for acetaminophen, antidepressants (except duloxetine), skeletal muscle relaxants, lidocaine patches, and transcutaneous electrical nerve stimulation in the treatment of chronic low back pain. there is strong evidence for short-term effectiveness and moderate-quality evidence for long-term effectiveness of yoga in the treatment of chronic low back pain. various spinal manipulative techniques (osteopathic manipulative treatment, spinal manipulative therapy) have shown mixed benefits in the acute and chronic setting. physical therapy modalities such as the mckenzie method may decrease the recurrence of low back pain and health care expenditures. physical therapy modalities such as the mckenzie method may decrease the recurrence of low back pain and use of health care. educating patients on prognosis and incorporating psychosocial components of care such as identifying comorbid psychological problems and barriers to treatment are essential components of long-term management.
laterality is a well described phenomenon in domestic dogs. it was shown that dogs, under calm earth
the purpose of this study is to determine the effects of directional preference exercises in comparison to motor control exercises in patients with mechanical low back pain
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directional preference alignment. contribute to rlhflow/directional-preference-alignment development by creating an account on github.
if you are suffering from any musculoskeletal system disorder then you have feel at some point that some position make you feel better
neurons responding sensitively to motions in several rather than all directions have been identified in many sensory systems. although this directional preference has been demonstrated by previous studies to exist in the isthmi pars magnocellularis (imc) of pigeon (columba livia), which plays a key role in the midbrain saliency computing network, the dynamic response characteristics and the physiological basis underlying this phenomenon are unclear. herein, dots moving in 16 directions and a biologically plausible computational model were used. we found that pigeon imc’s significant responses for objects moving in preferred directions benefit the long response duration and high instantaneous firing rate. furthermore, the receptive field structures predicted by a computational model, which captures the actual directional tuning curves, agree with the real data collected from population imc units. these results suggested that directional preference in imc may be internally prebuilt by elongating the vertical axis of the receptive field, making predators attack from the dorsal-ventral direction and conspecifics flying away in the ventral-dorsal direction, more salient for avians, which is of great ecological and physiological significance for survival.
we are excited to announce our healthy back on-line exercise program.
the mckenzie method of mechanical diagnosis and therapy is a biopsychosocial system of musculoskeletal care emphasizing patient empowerment & self-treatment
published in 2016 by journal of orthopaedic and sports physical therapy. authors: knol d.,apeldoorn a.,ostelo r.,kamper s.,van helvoirt h.,meihuizen h.,tempelman h.,vandeput d.
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objectives: a detailed description of how directional preference (dp) constructs are measured could accelerate research to practice translation and improve research findings for mechanical diagnosis and therapy (mdt) stakeholders. a secondary ...
this course will help clinicians understand how the mckenzie system of mechanical diagnosis and therapy (mdt) can complement the australian approach to managing patients with lumbar spine dysfunction.
the prevalence of neck pain is estimated at 20-70% and represents the second leading musculoskeletal cause of disability in the united states. mechanical diagnosis and therapy (mdt) is a system of musculoskeletal examination and treatment which involves an analysis of the patient’s response to end range repeated movements. the testing of end range repeated movements may determine a direction of motion that improves the person’s symptoms and/or movement and is referred to as a directional preference (dp). the deep neck flexor test (dnft) assesses neuromuscular control of the cervical spine, which is often impaired in people with neck pain. a published case study of a person with neck pain found a relationship between directional preference and improved deep neck flexor strength. the purpose of this study is to determine the correlation between dp and neuromuscular control, as measured with the dnft, in patients referred for physical therapy at the catholic health system of buffalo, ny.
this resource is for clients wanting to take control of back pain that is radiating down the leg. directional preference exercise, or stretching in a direction that reduces or brings symptoms closer to your back, can be useful to help control symptoms early on during the rehabilitation process. this intervention outlines some strategies that can help move the pain out of the leg during recovery.
the developing directional preferences in writing and drawing that were observed in subjects between four years of age and adulthood suggest that two semiindependent motor systems are involved in writing: one for rapid and nonfigurative tasks, the other--which occurs later--for precision and symbolic functions. (author/gt)
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directional preference treatment is a type of exercise that targets the specific tissues responsible for a patient's symptoms.
find your directional preference for low back pain to identify your back's preferred movement direction for effective treatment.
get information on extension bias and how you might position your spine to manage your back pain and other symptoms.
researchers have been studying approaches to steer the behavior of large language models (llms) and build personalized llms tailored for various applications. while fine-tuning seems to be a direct solution, it requires substantial computational resources and may significantly affect the utility of the original llm. recent endeavors have introduced more lightweight strategies, focusing on extracting "steering vectors" to guide the model's output toward desired behaviors by adjusting activations within specific layers of the llm's transformer architecture. however, such steering vectors are directly extracted from the activations of human preference data and thus often lead to suboptimal results and occasional failures, especially in alignment-related scenarios. this work proposes an innovative approach that could produce more effective steering vectors through bi-directional preference optimization. our method is designed to allow steering vectors to directly influence the generation probability of contrastive human preference data pairs, thereby offering a more precise representation of the target behavior. by carefully adjusting the direction and magnitude of the steering vector, we enabled personalized control over the desired behavior across a spectrum of intensities. extensive experimentation across various open-ended generation tasks, particularly focusing on steering ai personas, has validated the efficacy of our approach. moreover, we comprehensively investigate critical alignment-concerning scenarios, such as managing truthfulness, mitigating hallucination, and addressing jailbreaking attacks. remarkably, our method can still demonstrate outstanding steering effectiveness across these scenarios. furthermore, we showcase the transferability of our steering vectors across different models/loras and highlight the synergistic benefits of applying multiple vectors simultaneously.
join dr. b for a practical and entertaining presentation that provides an evidence-based synopsis of the top five treatment classifications for low back pain. understanding these classifications will help you consistently predict the most appropriate management and home care recommendations. attende
fine-grained control over large language models (llms) remains a significant challenge, hindering their adaptability to diverse user needs. while reinforcement learning from human feedback (rlhf) shows promise in aligning llms, its reliance on scalar rewards often limits its ability to capture diverse user preferences in real-world applications. to address this limitation, we introduce the directional preference alignment (dpa) framework. unlike the scalar-reward rlhf, dpa incorporates multi-objective reward modeling to represent diverse preference profiles. additionally, dpa models user preferences as directions (i.e., unit vectors) in the reward space to achieve user-dependent preference control. our method involves training a multi-objective reward model and then fine-tuning the llm with a preference-conditioned variant of rejection sampling finetuning (rsf), an rlhf method adopted by llama 2. this method enjoys a better performance trade-off across various reward objectives. in comparison with the scalar-reward rlhf, dpa offers users intuitive control over llm generation: they can arithmetically specify their desired trade-offs (e.g., more helpfulness with less verbosity). we also validate the effectiveness of dpa with real-world alignment experiments on mistral-7b. our method provides straightforward arithmetic control over the trade-off between helpfulness and verbosity while maintaining competitive performance with strong baselines such as direct preference optimization (dpo).