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Reliability of goniometric measurements in children with spastic cerebral palsy
Akmer Mutlu1, Ayse Livanelioglu, Mintaze Kerem Gunel
1Cerebral Palsy Unit, School of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey. akmermutlu@yahoo.com
Insights
Goniometric measurements are reliable for assessing range of motion in children with spastic diplegic cerebral palsy (CP). This study found high intra-test and inter-test reliability, supporting its clinical use.
Area of Science:
- Pediatric Physical Therapy
- Neuromuscular Disorders
- Biomedical Measurement
Background:
- Spastic diplegic cerebral palsy (CP) affects motor function, necessitating reliable assessment tools.
- Goniometric measurement is a common method for evaluating joint range of motion.
Purpose of the Study:
- To determine the reliability of goniometric measurements for joint range of motion in children with spastic diplegic CP.
- To assess both intra-test and inter-test reliability of these measurements.
Main Methods:
- A prospective, cross-sectional, observational study involving 38 children with spastic diplegic CP.
- Passive range of motion (PROM) of key joints was measured using universal goniometry by three physical therapists over two sessions.
- Intra-class correlation coefficients (ICCs) were calculated to assess intra- and inter-test reliability.
Main Results:
- High inter-test reliability was observed (p<0.01), with ICC values ranging from 0.61 (hip abduction) to 0.95 (hip extension).
- Intra-test reliability was also high across all therapists, with experienced therapists showing slightly better results.
- Mean absolute differences between sessions were generally small (0.10-4.86 degrees).
Conclusions:
- Goniometric measurements demonstrate high reliability for assessing joint range of motion in children with spastic diplegic CP.
- The findings support the routine use of goniometry in the clinical evaluation of this population.
Background:
A prospective, cross-sectional, observational study was designed to determine the reliability of goniometric measurements in children with spastic diplegic cerebral palsy (CP).
Material/Methods:
The study included 38 children with spastic diplegic CP. Passive range of motion (PROM) of hip extension, abduction, and external rotation, hip flexion with knee extended, and ankle dorsi flexion was measured using universal goniometry. Each child was assessed by three physical therapists once in each session on two different sessions a week apart. Intra-test reliability was determined by paired comparison of measurements for each therapist across the two assessments. Inter-test reliability was determined by paired comparisons of the three therapists' measurements on the same session. The interclass correlation coefficient (ICC) was calculated for intra- and inter-test reliability.
Results:
The mean absolute differences for all measures between sessions ranged from 0.10-4.86 degrees for the three physical therapists. There was no statistical significance in the mean differences between the physical therapists in all measurements (p>0.05) except for hip flexion with the knee extended (p<0.05). Inter-test reliability was high (p<0.01). The highest ICC value was 0.95 for hip extension and the lowest was 0.61 for hip abduction. Although the intra-testing reliability scores were high for all the physiotherapists, the most experienced physiotherapists' results were higher compared with the others.
Conclusions:
The results from this study encourage the use of goniometric measurements in assessing children with spastic diplegic CP.
