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Inter-rater reliability of physiotherapists using the Pirani scoring system for clubfoot: comparison with a modified
Nicole J Harvey1, Anita J Mudge, Deborah T Daley
1aDepartment of Physiotherapy, Sydney Children's Hospital, Sydney Children's Hospitals Network bDiscipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia.
Abstract:
This study examines inter-rater reliability between physiotherapists using the Pirani scoring system for clubfoot, and whether the addition of two scale points to give a modified five-point severity scale improves reliability. A total of 65 infant feet were assessed by two raters, with 21 different rater combinations used. The Pirani scoring system was found to be a reliable assessment tool when used by physiotherapists to score clubfoot, with a minimum of fair to good inter-rater reliability demonstrated across all clinical signs. The modified five-point scale proved significantly more reliable than the three-point scale; however, the benefit is not sufficient to warrant varying the original three-point scale.
