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[Testing range of motion in cerebral palsy]
E Viehweger1, C Bérard, A Berruyer
1Service de chirurgie orthopédique-pédiatrique, centre d'analyse du mouvement, hôpital Timone-Enfants, université de la méditerranée, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. elke.viehweger@ap-hm.fr
Insights
A standardized lower-limb joint range of motion test for pediatric cerebral palsy was developed using expert consensus and literature review. This new test aids clinical communication and database development for improved patient care.
Area of Science:
- Orthopedics
- Pediatric Rehabilitation
- Neurology
Context:
- Cerebral palsy (CP) significantly impacts joint range of motion (ROM) in children.
- Standardized ROM assessment is crucial for effective management and research in pediatric CP.
- Current assessment methods lack uniformity, hindering consistent data collection and comparison.
Purpose:
- To develop and propose a standardized joint range of motion (ROM) test for pediatric patients with cerebral palsy (CP).
- To establish a reliable and consistent method for assessing lower-limb ROM in children with CP.
- To facilitate better clinical communication and database development for CP research.
Summary:
- A comprehensive lower-limb joint range of motion (ROM) test was created through an adapted Delphi process involving 16 specialists.
- The finalized test comprises 24 goniometric measurements in supine and prone positions, with essential conditions for accurate examination.
- A detailed testing guide with visual aids for proposed exam techniques was also developed.
Impact:
- The standardized test promotes consistent communication among clinicians managing pediatric cerebral palsy.
- It lays the groundwork for creating a valuable database to track CP progression and treatment outcomes.
- Future development includes patient-specific booklets for monitoring growth and radiographic measurements.
Objectives:
To propose a standardized test of joint range of motion in paediatric patients with cerebral palsy, based on the opinion of a cerebral palsy specialist group (physicians, physiotherapists and surgeons) and literature review.
Materials And Methods:
A Delphi process was adapted to elaborate a complete test of lower-limb-joint range of motion. During the preparation phase, a pilot committee selected a list of items compiled from literature search and personal experience. A first questionnaire was proposed to 16 experts, then six discussion meetings followed. From the results, the pilot committee prepared a second questionnaire for the experts and finalized the complete test of joint range of motion.
Results:
The complete test includes 24 items related to goniometric measurements in supine and prone positions. Principal conditions necessary for an accurate exam are included. Further, a testing guide with visuals of the proposed exam techniques was developed.
Conclusions:
The standardized testing of lower-limb-joint range of motion will allow for better communication between clinicians and will facilitate the development of a database. Care should be taken in the interpretation of the joint range-of-motion test results and realized only after reliability analysis of the test, especially interobserver reliability. A further step would be to develop an outpatient booklet for cerebral palsy that shows growth and weight curves, joint range-of-motion curves and curves of the principal radiographic measurements during growth.
