Electronic Thesis and Dissertation Repository


Master of Science


Health and Rehabilitation Sciences


Dr. Shawn Robbins


Objective: The purpose of this thesis was to investigate the inter-rater reliability of the McKenzie System of Mechanical Diagnosis and Therapy (MDT) when classifying patients with musculoskeletal knee pain using clinical vignettes. Methods: This study was divided into two phases. First, ten clinicians experienced in the use of MDT were randomly recruited to write a total of 60 clinical vignettes based upon the initial assessment of past patients with knee pain. Second, six different MDT raters were recruited to rate 53 selected vignettes and reliability was determined using Fleiss Kappa. Results: There was “substantial agreement” among six MDT raters classifying the clinical vignettes into one of four categories (kappa=0.72). There was no statistically significant difference between therapists with different levels of training. Significance: These findings indicate that the McKenzie System of MDT is a reliable method of classifying patients presenting with musculoskeletal knee pain when using clinical vignettes.