Mechanical diagnosis and therapy in patients with extremity problems: A Systematic review
DOI:
https://doi.org/10.46858/VIMSJPT.3210Keywords:
MDT, EXTREMITY JOINTS, KNEE, RCTAbstract
Background: Mechanical Diagnosis and Therapy (MDT) is used in the treatment of extremity problems. It is an effective approach in cases of spinal conditions for target population. Availability of the reliable data like RCT and systematic review is a key factor to determine the precise clinical problem and to direct an appropriate intervention.
Objectives: The primary aim of this systematic review is to assess the methodological quality of well-designed RCTs related to the MDT classification and treatment for extremity problems.
Design: Systematic review.
Method: Electronic search on various data bases was done. The level of evidence was determined considering the methodological quality of the studies.
Results: 1 RCT was included and it met the criteria for high quality. After the assessment of RCT according to the CONSORT guidelines it was found that out of 25 checklist points; 4 methodological faults were found in assessed RCT. Those were; a) sample size determination, b) Blinding after assessment c) Generisability of the trial findings d) Where the full trial protocol can be accessed.
Conclusion: The current systematic review found strong evidence of benefits of MDT approach for extremity problems (knee joint). But there was limited evidence in other extremity joints.
References
Levine D. The Human Extremities: Mechanical Diagnosis and Therapy. Physical Therapy. 2001 Sep 1;81(9):1597.
Heidar Abady A. Application of The McKenzie System Of Mechanical Diagnosis And Therapy In Patients With Shoulder Disorders.2018.
Schellingerhout JM, Verhagen AP, Thomas S, Koes BW. Lack of uniformity in diagnostic labeling of shoulder pain: time for a different approach. Manual therapy. 2008 Dec 1;13(6):478-83.
May S, Ross J. The McKenzie classification system in the extremities: a reliability study using McKenzie assessment forms and experienced clinicians. Journal of manipulative and physiological therapeutics. 2009 Sep 1;32(7):556-63
Takasaki H, Okuyama K, Rosedale R. Inter-examiner classification reliability of mechanical diagnosis and therapy for extremity problems–systematic review. Musculoskeletal Science and Practice. 2017 Feb 1;27:78-84.
Moher D, Jones A, Lepage L, Consort Group, CONSORT Group. Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation. Jama. 2001 Apr 18;285(15):1992-5.
Maccio JR, Carlton L, Levesque K, Maccio JG, Egan L. Directional preference of the extremity: a preliminary investigation. Journal of Manual & Manipulative Therapy. 2018 Oct 20;26(5):272-80.
Rosedale R, Rastogi R, May S, Chesworth BM, Filice F, Willis S, Howard J, Naudie D, Robbins SM. Efficacy of exercise intervention as determined by the McKenzie system of mechanical diagnosis and therapy for knee osteoarthritis: a randomized controlled trial. journal of orthopaedic & sports physical therapy. 2014 Mar;44(3):173-A6.
Aytona MC, Dudley K. Rapid resolution of chronic shoulder pain classified as derangement using the McKenzie method: a case series. Journal of Manual & Manipulative Therapy. 2013 Nov 1;21(4):207-12.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Mrudula Shete, Dr. Deepak B. Anap
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
