Attitude towards the use of mechanical diagnosis and therapy and reliability of classification extremity problems by credentialed therapists.

Objective The purpose of this study was to investigate attitudes towards Mechanical Diagnosis and Therapy (MDT) for extremity problems and inter-examiner reliability of classifying extremity problems into MDT subgroups by credentialed practitioners in MDT (Cred.MDT) in Japan. Methods A cross-sectional survey was used and all 120 Cred.MDT practitioners registered in the McKenzie Institute International Japan branch were asked about their attitude towards MDT for extremity problems and were asked to select the most appropriate MDT subgroup for each of the 25 extremity patient vignettes. Model classifications were used to investigate accuracy of classification. Percent agreement and Kappa analyses were examined. Results Sixty practitioners (50%) participated in this study. For the management of patients with extremity problems, the majority did not use MDT most of the time (53%) due to a lack of confidence in using MDT in the extremities (78%). The overall accuracy for their MDT classification for extremity problems was 87% (Fleiss's κ = 0.78). Conclusions The majority of the Cred.MDT practitioners in Japan did not use MDT frequently and were not confident to use MDT with extremity patients. However, accuracy and inter-examiner agreement of their MDT classification from the information on the assessment sheet was good.