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Inter‐ and intrarater clinician agreement on joint motion patterns during gait in children with cerebral palsy
Author(s) -
Nieuwenhuys Angela,
Papageorgiou Eirini,
Molenaers Guy,
Monari Davide,
Laet Tinne,
Desloovere Kaat
Publication year - 2017
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13404
Subject(s) - cerebral palsy , gait , ankle , range of motion , physical medicine and rehabilitation , gross motor function classification system , physical therapy , kappa , gait analysis , spastic , medicine , psychology , surgery , mathematics , geometry
Aim This study aimed to quantify the inter‐ and intrarater clinician agreement on joint motion patterns in children with spastic cerebral palsy ( CP ), which were recently specified by a Delphi consensus study. It also examined whether experience with three‐dimensional gait analysis (3 DGA ) is a prerequisite for using the patterns. Method The experimental group consisted of 82 patients with CP (57 males, 25 females; uni‐/bilateral CP [ n =27/55]; Gross Motor Function Classification System levels I to III; mean age 9y 5mo [range 4y–18y]). Thirty‐two clinicians were split into ‘experienced’ and ‘inexperienced’ rater groups. Each rater was asked to classify 3 DGA reports of 27 or 28 patients twice. Inter‐ and intrarater agreement on 49 joint motion patterns was estimated using percentage of agreement and kappa statistics. Results Twenty‐eight raters completed both classification rounds. Intrarater agreement was ‘substantial’ to ‘almost perfect’ for all joints (0.64< ĸ <0.91). Interrater agreement reached similar results (0.63< ĸ <0.86), except for the knee patterns during stance ( ĸ =0.49, ‘moderate agreement’). Experienced raters performed significantly better on patterns of the knee during stance and ankle during swing. Interpretation Apart from some specific knee patterns during stance and ankle patterns during swing, the results suggested that clinicians could use predefined joint motion patterns in CP with good confidence, even in case of limited experience with 3 DGA .