Inappropriate patient sexual behaviors.
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Biomedical subjects
Publications and source records attributed to J M Rothstein.
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The McKenzie system for examining and treating patients with low back pain is frequently used by clinicians. The primary purpose of this multicenter study was to determine the intertester reliability of assessments of patients with low back pain when physical therapists used the McKenzie method. A second purpose was to determine if previous postgraduate training in the McKenzie system affects reliability. Some therapists had previously undertaken postgraduate training in the McKenzie system. All therapists were given written descriptions of the McKenzie method and the criteria used to classify patients. Classifications were made on 363 patients with low back pain by randomly paired physical therapists in eight clinics. The Kappa value on agreement of patient classification was 0.26, which suggests poor reliability. Therapists agreed on which syndrome was present 39% of the time. Previous postgraduate training did not improve reliability. The results suggest that assessments of the syndrome present in patients with low back pain appear to be unreliable when using the McKenzie system.
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The purpose of this study was to develop and test a protocol that could be used to obtain reliable measurements of knee extensor torque produced during maximal voluntary contractions. On each of 3 days, 10 subjects performed six consecutive maximal voluntary contractions, in the same randomized order, for each of the following 10 conditions: concentric isokinetic contractions at velocities of 30 degrees, 90 degrees, 120 degrees, and 180 degrees/s; eccentric isokinetic contractions at velocities of 30 degrees, 90 degrees, 120 degrees, and 180 degrees/s; and isometric contractions at 40 and 60 degrees of knee flexion. The peak torques produced were examined to determine on which day and during which contraction subjects produced the greatest torques for each condition. This information was used to develop a practice protocol. Fifteen different subjects were tested following this protocol. Subjects participated in two practice sessions, a test session, and a retest session. Intraclass correlation coefficients (ICCs) were calculated to determine the degree of agreement between torques for the test and retest sessions. The ICCs ranged from .87 to .98. The protocol developed appears to be useful for obtaining reliable measurements of knee extensor torque.
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Bulimia nervosa is an eating disorder found predominantly in young females and characterized by binge-purge cycles as well as medical and psychological problems. The patient with bulimia may present to the otolaryngologist with an upper aerodigestive complaint. It is of paramount importance that the otolaryngologist be cognizant of the disease in order to refer the patient for further therapy.