Interrater Agreement on Assessment, Diagnosis, and Treatment for Neck Pain by Trained Physical Therapist Students

Bybee, Ronald F.; Dionne, Carol P.

doi:10.1097/00001416-200707000-00007

Cited by 11 publications

(7 citation statements)

References 36 publications

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“…All patient management was overseen by the lead author. Bybee et al [21] found MDT-trained physical therapist students to be as reliable as experienced clinicians trained in MDT for diagnosis and treatment of patients with neck pain. Acceptable treatment and clinical outcomes have been achieved by MDT-trained student physical therapists under the guidance and monitoring of skilled MDT clinicians in the elbow, wrist, and cervical spine [8,17,22].…”

Section: Methodsmentioning

confidence: 99%

Directional preference of the extremity: a preliminary investigation

Maccio

Carlton

Levesque

et al. 2018

Journal of Manual & Manipulative Therapy

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Background: Mechanical diagnosis and therapy (MDT) is a specific classification-based musculoskeletal examination and intervention system that uses repeated end range and sustained movement to classify patients into mechanical syndromes. Research has recently demonstrated increased prevalence, reliability, and efficacy of MDT syndromes in varied peripheral musculoskeletal populations. There is currently no research analyzing if predictive variables exist for establishing directional preference in peripheral joints, other than the wrist. The aim of this study was to examine the clinical application of predictive variables for establishing directional preference and spinal referral in patients with isolated peripheral joint pain. Case Description: Thirty-seven consecutive patients with isolated peripheral pain were evaluated and classified using MDT assessment. Secondary analysis of predetermined variables was performed for association with directional preference and identification of spinal referral in Derangement syndrome. Results: All 37 patients were classified using MDT assessment. Thirty-three (89.2%) were classified as Derangement syndrome: 17 as spinal Derangement (45.9%) and 16 as peripheral Derangement (43.2%). One peripheral derangement also had an underlying Articular Dysfunction. Additionally, there were four patients classified as Other (10.8%). Discussion: Historical and physical examination findings were analyzed to determine if there were associated variables of directional preference or spinal referral. Mechanical stress was found to be the most associated factor in predicting directional preference. No peripheral movement loss, paresthesia, and constant pain were more associated with spinal referral. These findings may lead to a greater understanding of peripheral MDT assessment, which may lead to increased identification of directional preference and improved patient outcomes.

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Section: Methodsmentioning

confidence: 99%

Directional preference of the extremity: a preliminary investigation

Maccio

Carlton

Levesque

et al. 2018

Journal of Manual & Manipulative Therapy

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“…MDT allows for the treatment to adapt as patient presentation changes. MDT also follows referral patterns and symptomatic and mechanical responses to repeated movements to confirm findings in a safe and more reliable manner [10][11][12][13][32][33][34]. Without an initial MDT evaluation prior to surgery, it is difficult to say if the appropriate level received the surgical intervention with only MRI results dictating treatment.…”

Section: Orthopedics and Rheumatology Open Access Journalmentioning

confidence: 99%

Untitled

2017

OROAJ

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The prevalence of neck pain is estimated to be 30-50 % in the general population, the second leading source of reported pain in the United States. There is limited research on the use of mechanical diagnosis and therapy (MDT) on patients with cervical pain. The effects and safety of MDT assessment and treatment for failed anterior cervical discectomy and fusion (ACDF) has yet to be established. This case report presents a 42-year-old female with a complaint of worsening neck pain with intermittent radiculopathy after an ACDF to address cervical radiculopathy. The patient received a MDT evaluation and was classified as a thoracic spine derangement. The patient was treated based on mechanical and symptomatic responses to repeated movements and mobilizations using principles of MDT. Short-and long-term outcomes were excellent, demonstrating rapid abolishment of symptoms and improvement of function in 6 visits over 4 weeks. The patient reported no pain or functional disability and had returned to all work and recreational activities. The patient demonstrated the ability to prevent and manage recurrence of symptoms independently at one-year follow-up. This case report confirms the efficacy and safety of MDT evaluation after a failed ACDF. The patient was successfully managed using MDT with full resolution of symptoms. This case report provides preliminary evidence that MDT may provide effective short-and long-term outcomes after failed ACDF. Less invasive, conservative methods, such as MDT, may be more effective at resolving cervical radiculopathy. Level of evidence 4.

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“…Yet several studies have shown higher interrater reliability for manual therapy examination and diagnosis for students and novices than for experienced clinicians and no differences between novice and experienced clinicians with regard to biomechanical parameters of a thoracic thrust technique. [21][22][23][24] In a secondary analysis of data from the CPR validation study discussed above, 13 Whitman and colleagues reported that therapist experience with manual therapy did not affect patient outcome with manipulation. 25 In fact, they noted a trend for greater functional improvement in patients manipulated by therapists with less experience and a significantly greater improvement for patients treated by therapists without postgraduate certification.…”

Section: Arguments Against Including Spinal Thrust Manipulation In Enmentioning

confidence: 99%