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Day: June 1, 2017

Anterior Approach

By London Spine

Incision Spinal Preparation Screw & Rod Placement Fusion What is it? There are several different approaches that a surgeon will use to correct spinal deformity such as scoliosis and kyphosis, including the traditional posterior approach, an anterior approach, or both. The anterior approach to scoliosis means that the surgeon will approach the spinal column from…

The psychometric properties of the PABS-PT in neck pain patients: A validation study.

By London Spine
Related Articles

The psychometric properties of the PABS-PT in neck pain patients: A validation study.

Man Ther. 2014 Jan 18;

Authors: Mutsaers JH, Pool-Goudzwaard AL, Ostelo RW, Peters R, Koes BW, Verhagen AP

Abstract
OBJECTIVE: This study aims to assess the reliability and validity of the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) in neck pain patients. Three research goals were formulated. (1): to reexamine the factor structure of the PABS-PT, (2) to assess the test-retest reliability of the PABS-PT and (3) to determine the construct validity of the biomedical factor of the PABS-PT.
METHODS: Manual therapists (n = 272) included in this study participated in an educational upgrade program for a professional masters’ degree in the Netherlands and completed the Health Care Providers’ Pain and Impairment Relationship Scale and the PABS-PT. Principal Axis Factor analysis was performed and correlation coefficients were calculated. In addition, Bland and Altman plots and the smallest real difference were determined.
RESULTS: We performed factor analysis on 182 questionnaires and test-rest calculations on 73 questionnaires. The principal factor analysis confirmed the existing interpretable 2-factor model of a ‘biomedical treatment orientation’ and a ‘behavioral treatment orientation’. Test-retest reliability was ‘moderate’ to ‘good’ and construct validity for the biomedical factor was ‘moderate’ to ‘substantial’.
CONCLUSION: The PABS-PT shows a consistent factor structure and good test-retest reliability and construct validity. More research is needed to gain further insight in the interplay between implicit and explicit attitudes and the dynamics of the PABS-PT score across different body parts.

PMID: 24560002 [PubMed – as supplied by publisher]

McKenzie Lumbar Classification: Inter-Rater Agreement by Physical Therapists with Different Levels of Formal McKenzie Post-Graduate Training.

By London Spine
Related Articles

McKenzie Lumbar Classification: Inter-Rater Agreement by Physical Therapists with Different Levels of Formal McKenzie Post-Graduate Training.

Spine (Phila Pa 1976). 2013 Nov 18;

Authors: Werneke MW, Deutscher D, Hart DL, Stratford P, Ladin J, Weinberg J, Herbowy S, Resnik L

Abstract
Study Design. Inter-rater chance-corrected agreement studyObjective. The aim was to examine the association between therapists’ level of formal pre-credential McKenzie post-graduate training and agreement on the following McKenzie classification variables for patients with low back pain (LBP): main McKenzie syndromes, presence of lateral shift, derangement reducibility, directional preference and centralization.Summary of Background Data. Minimal level of McKenzie post graduate training needed to achieve acceptable agreement of McKenzie classification system is unknown.Methods. Raters (N = 47) completed multiple sets of 2 independent successive examinations at 3 different stages of McKenzie post-graduate training (levels Part A&B, Part C, and Part D). Agreement was assessed with kappa coefficients and associated 95% confidence intervals (CIs). A minimum kappa threshold of 0.60 was used as a pre-determined criterion for level of agreement acceptable for clinical use.Results. Raters examined 1,662 patients (mean age = 51 ± 15, Min, Max: 18 to 91, 57% women). Data distributions were not even and were highly skewed for all classification variables. No training level studied had acceptable agreement for any McKenzie classification variable. Agreements for all levels of McKenzie post-graduate training were higher than expected by chance for most of the classification variables except Part A&B training level for judging lateral shift and centralization and Part D training level for judging reducibility. Agreement between training levels Part A&B, Part C, and Part D were similar with overlapping 95% CIs.Conclusion. Results indicate that level of inter-rater chance corrected agreement of McKenzie classification system was not acceptable for therapists at any level of formal McKenzie post graduate training. This finding raises concerns about the clinical utility of the McKenzie classification system at these training levels. Additional studies are needed to assess agreement levels for therapists who receive additional training or experience at the McKenzie credentialed or diploma levels.

PMID: 24253786 [PubMed – as supplied by publisher]