INTERTESTER RELIABILITY OF MCKENZIE CLASSIFICATIONS OF THE SYNDROME TYPES PRESENT IN PATIENTS WITH LOW-BACK-PAIN

The McKenzie system for examining and treating patients with low back pain is frequently used by clinicians. The primary purpose of this mul ticenter study was to determine the intertester reliability of assessm ents of patients with low back pain when physical therapists used the McKenzie method. A second purpose was to determine if previous postgra duate training in the McKenzie system affects reliability. Some therap ists had previously undertaken postgraduate training in the McKenzie s ystem. All therapists were given written descriptions of the McKenzie method and the criteria used to classify patients. Classifications wer e made on 363 patients with low back pain by randomly paired physical therapists in eight clinics. The Kappa value on agreement of patient c lassification was 0.26, which suggests poor reliability. Therapists ag reed on which syndrome was present 39% of the time. Previous postgradu ate training did not improve reliability. The results suggest that ass essments of the syndrome present in patients with low back pain appear to be unreliable when using the McKenzie system.