Cook C, Anson E, Camacho C, Gwilliam B; Texas Tech University Health Sciences Center, Odessa, Texas. chad.cook@ttuhsc.edu.

PURPOSE: The purpose of the study was to determine if a standardized educational intervention could improve the inter-therapist reliability in physical therapy students. Low inter-therapist reliability determining R1, is reported in numerous studies. A lack of a standardized teaching method for mobilizations is frequently suggested as a reason for the poor reliability. SUBJECTS: In a pre/post-test repeated measures design, 12 master’s level physical therapy students (4 third year, 8 second year) performed three sets of mobilization oscillations in an attempt to find R1 as described by Maitland (2001). METHOD: The mobilization force of R1 was indirectly measured using the Kistler Force Plate. A one-hour educational session was administered between pre- and post-testing which consisted of movement diagrams, theoretical application of R1, interactive feedback using the force plate and weight scale, and linear elasticity education. ANALYSIS: Using SPSS 10.0.1 a model (2,1) Intraclass correlation (ICC) was performed to measure the inter student reliability of the assessment of R1. Since no statistical comparative measure exists for two ICC scores, confidence interval overlap was assessed to determine differences between pre- and post-testing. RESULTS: Pre-test values were poor (ICC = 0.027; p = 0.309). The post-test scores did show improved reliability greater than chance (ICC = 0.416; p < 0.0001). Post-test and Pre-test values did overlap using the confidence interval assessment, likely due to a small sample size. CONCLUSION: Though the post-test scores were not significantly better than the pre-test scores (via confidence interval overlap) the trend toward improved reliability warrants further investigation of the education protocol. CLINICAL RELEVENCE: Standardization of therapeutic mobilization forces could improve inter-clinician consistency in treatment and assist in validation of manual therapy concepts. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

Reprint Information
Requests for reprints should be directed to the corresponding author of the article. Students and other academic customers may receive permission to reprint copyrighted material from Physical Therapy by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Similar inquiries by all others should be made to the APTA Editorial Office, Attn: Physical Therapy.