Provider reliability with interventions for knee impairments: a preliminary investigation to facilitate development of an MDT-based knee intervention taxonomy

Abstract

ABSTRACTObjectives: The lack of a standardized intervention taxonomy in comparative effectiveness research trials has led to uncertainty regarding the management of individuals with knee impairments. Inconsistently and poorly defined interventions affect frontline–care providers’ abilities to understand and assimilate research findings into practice. An intervention taxonomy could help overcome the lack of treatment specificity commonly found in research trials.Methods: In the present study, we aimed to develop a Mechanical Diagnosis and Therapy (MDT)–based taxonomy and test the levels of reliability between providers who currently manage individuals with knee impairments in a rehabilitation setting. A total of 182 participants accessed the study during the study period, in which 180 consented to participate and 59 completed the survey (98.9% participation rate; 32.7% completion rate).Results: A total of 89.8% of the participants who completed the survey were physical therapists. Fleiss kappa values for the primary, secondary, and tertiary categories were 0.90, 0.89, and 0.71, respectively. The results of our investigation suggest substantial to almost perfect levels of reliability for identifying diverse MDT-based knee interventions displayed in video and vignette format within a sample population primarily of physical therapists who currently manage individuals with knee impairments in a rehabilitation setting.Discussion: Our findings show acceptable levels of reliability and provide support for using this standardized MDT-based intervention taxonomy as a way to improve intervention specificity and generalizability in comparative effectiveness research.Level of Evidence: 5