Call Girl Lucknow Mallika 7001305949 Independent Escort Service Lucknow
Spinal Evaluation Techniques: 2000 McKenzie Institute North American Conference
1. Spinal Evaluation Techniques
A Survey Of Entry-Level Physical Therapy
Curricula In The United States, Canada, Australia,
New Zealand, And The United Kingdom
Allan Besselink, P.T., Dip.MDT
Austin, TX
Jeffrey Witten, MSPT
San Antonio, TX
2. Educational Process
• Curriculum content (what)
– validity
– reliability
– relevance
• Perception of importance of content (why)
• Clinical reasoning (how)
3. Purpose
• Establish current trends in spinal evaluation
curriculum content in entry-level physical
therapy educational programs
• Provide a foundation for further comparison
with the literature on reliability and validity
of spinal evaluation techniques
4. Methods And Research Design
• Survey consisting of questions regarding -
– 1. Authors or references cited in the
development of the curriculum content
– 2. Evaluation techniques taught in the
curriculum
– 3. Relative importance of each technique to the
overall scope of the spinal evaluation
curriculum
5. Survey Results
• Survey sent to 195 entry-level physical
therapy educational programs
– 148 United States, 47 International
• Return rate of 62.6 % (n = 122)
– 93 United States, 29 International
– 53 Bachelors (43.4 %) - 28 International
– 69 Masters (56.6 %) - 68 United States
7. Curriculum - Content
• “The Big 2”
– McKenzie 95.1%
– Maitland 93.4%
• United States
– The Big 2, Cyriax, Kaltenborn, Paris, Kendall
• International
– The Big 2, Butler, Grieve, Cyriax, Janda
8. Curriculum - Content
• References that critically examine the
current status of spinal evaluation and
treatment:
– Spitzer et al 1987 (QTF) 5.7 %
• United States 1.1%
• International 20.7%
13. Relative Importance
• What is the relative importance of each
technique to the overall scope of the spinal
evaluation curriculum?
• Prioritized ranking of 0 - 10
– 0 = “no priority/not taught”
– 10 = “high priority/great deal of time spent on
that particular technique”
14. Relative Importance by Rank
• International • United States
– Neurological – Asymmetry
– ROM/Mobility – Neurological
– Palpation – Palpation
– PIVM – Flexibility
– ROM/Mobility
15. Relative Importance by Mode
• International • United States
– Palpation – Palpation
– ROM/Mobility – Asymmetry
– Provocative Spine – Repeated
– PIVM Movements
– Neurological – PIVM
– Neural Tension – Neurological
– Pain Patterns
16. Faculty Profile
International United States
Gender M/F 20.7/55.2 57.0/38.7
Certification 38.0 38.6
Active 79.3 79.6
Hours 0-25 (3) 0-35 (10)
Years 0-35 (10) 0-25 (10)
18. Treatment Preferences
• Battie et al - Physical Therapy 1994
– 48% rated the McKenzie method as the “most
useful” approach
– 56.4% “poorly prepared at entry” to clinical
practice
19. Treatment Preferences
• Foster et al - Spine 1999
– treatment preferences in Britain and Ireland
– “The Big 2”
• 58.9% utilize Maitland
• 46.6% utilize McKenzie
20. Conclusions
• Current trends in entry-level physical
therapy spinal evaluation curriculum
• Consensus-based versus Evidence-based
curricula
• Are we preparing physical therapists for
entry-level practice?
21. Acknowledgements
• Iain Muir (Canada)
• Richard Dale (Canada)
• Harry Papagoras (Australia)
• Mark Laslett (New Zealand)
• Malcolm Robinson (United Kingdom)
22. Implications To MII
• McKenzie is referenced but repeated
movements are not perceived as important
by instructors
• McKenzie method is becoming well-
supported as an assessment technique
• Clinicians are poorly prepared at entry level
• Clinicians eventually rate it as effective
