The McKenzie Classification System in the Extremities: A Reliability Study Using Mckenzie Assessment Forms and Experienced Clinicians

Attitude Towards the Use of Mechanical Diagnosis and Therapy and Reliability of Classification Extremity Problems by Credentialed Therapists

“…9 However, the majority of practitioners using MDT clinical practice do not hold the Dip.MDT. Therefore the attitude towards MDT for extremity problems and inter-examiner classification reliability in the previous study 8 may not be generalized to the majority of practitioners with Cred.MDT clinical practice. Thus, it was warranted to investigate the attitude towards MDT for extremity problems and inter-examiner classification reliability using the same patient vignettes in Cred.MDT practitioners.…”

“…This study used the same vignettes used in the previous study with no translation from English to Japanese although vignette's number was relabeled to avoid participants knowing the correct classification from the previous study. 8 Each vignette had information regarding: 1) demographics, 2) pain location, 3) current and previous history, and 4) physical examination findings including active and passive movement testing, resisted testing and repeated movement responses. Participants were asked to choose the most appropriate MDT subgroup for each vignette from the following six subgroups: Derangement, Articular Dysfunction, Contractile Dysfunction, Posture, Spinal, or Other.…”

“…8 The overall accuracy that was the mean of accuracy over the 25 vignettes, and the means of the accuracy in the 12 vignettes with upper limb complaint and the 13 vignettes with lower limb complaint were calculated. To investigate interexaminer agreement for the MDT classification, Fleiss's κ was calculated over the 25 vignettes, the 12 vignettes with upper limb problem and the 13 vignettes with lower limb problem.…”

“…Features of the four subgroups except the 'Spinal' and 'Other' are detailed in elsewhere. 8 'Spinal' means that the extremity problem is associated with spine. 'Other' means that the problem does not fit in any of the five subgroups and MDT may not be appropriate as an effective management for the complaint (e.g.…”

“…In a previous study, 8 inter-examiner agreement for the MDT classification corresponding to 25 extremity patient vignettes were investigated in Dip.MDT therapists. The study showed that 96% of the Dip.MDT practitioners used MDT for extremity patients all the time or most of the time.…”