Riddle D L, Rothstein J M
Department of Physical Therapy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond.
Spine (Phila Pa 1976). 1993 Aug;18(10):1333-44. doi: 10.1097/00007632-199308000-00013.
The McKenzie system for examining and treating patients with low back pain is frequently used by clinicians. The primary purpose of this multicenter study was to determine the intertester reliability of assessments of patients with low back pain when physical therapists used the McKenzie method. A second purpose was to determine if previous postgraduate training in the McKenzie system affects reliability. Some therapists had previously undertaken postgraduate training in the McKenzie system. All therapists were given written descriptions of the McKenzie method and the criteria used to classify patients. Classifications were made on 363 patients with low back pain by randomly paired physical therapists in eight clinics. The Kappa value on agreement of patient classification was 0.26, which suggests poor reliability. Therapists agreed on which syndrome was present 39% of the time. Previous postgraduate training did not improve reliability. The results suggest that assessments of the syndrome present in patients with low back pain appear to be unreliable when using the McKenzie system.
临床医生经常使用麦肯齐系统来检查和治疗腰痛患者。这项多中心研究的主要目的是确定物理治疗师使用麦肯齐方法时，对腰痛患者评估的测试者间可靠性。第二个目的是确定之前在麦肯齐系统的研究生培训是否会影响可靠性。一些治疗师之前接受过麦肯齐系统的研究生培训。所有治疗师都收到了关于麦肯齐方法和用于对患者进行分类的标准的书面描述。在八个诊所中，由随机配对的物理治疗师对363名腰痛患者进行分类。患者分类一致性的Kappa值为0.26，这表明可靠性较差。治疗师在39%的时间里对存在哪种综合征达成了一致。之前的研究生培训并没有提高可靠性。结果表明，使用麦肯齐系统时，对腰痛患者存在的综合征的评估似乎不可靠。
