Goniometric reliability for a child with spastic quadriplegia

Area of Science:

• Rehabilitation Medicine
• Pediatric Physical Therapy
• Neurology

Background:

• Assessing range of motion (ROM) is crucial for managing spastic quadriplegia.
• Goniometric measurements are commonly used but their reliability in pediatric populations requires evaluation.

Observation:

• Intrarater and interrater reliability of goniometric measurements were assessed in a 5-year-old child with severe spastic quadriplegia.
• Measurements included shoulder flexion, abduction, and elbow extension bilaterally.
• Percentage agreement was used to evaluate reliability.

Findings:

• Intrarater reliability exceeded interrater reliability for all measured motions.
• Significant variability in measurements was observed both within and between raters.
• Mean differences and ranges of differences highlighted measurement inconsistencies.

Implications:

• A variability of +/- 10-15 degrees in ROM measurements should be interpreted cautiously in children with severe spastic cerebral palsy.
• These findings suggest that larger changes are needed to confirm true functional improvement or decline.
• Standardized measurement protocols may enhance the reliability of goniometric assessments in this population.