Reliability of Joint Position Sense and Force Sense Measurements in Children with Developmental Coordination Disorder

Background: Quantitative assessment of proprioception in children with Developmental Coordination Disorder (DCD) is limited by methodological variability and the lack of developmentally appropriate protocols. Joint position sense (JPS) and force sense (FS) assessments are commonly used in adults; however, their reliability in pediatric populations has not been sufficiently established. The objective of this study was to evaluate the intra- and inter-rater reliability of adapted JPS and FS protocols in children with DCD and to determine whether the observed reliability supports the use of these methods in experimental research. Methods: A repeated-measurements reliability research design was employed. Twenty-eight children aged 10-15 years (mean age 12.86 years), with a mean body mass of 43.68 kg and a mean height of 149.32 cm, and with medically confirmed DCD, completed four proprioceptive tests: joint angle reproduction and differentiation, and force reproduction and differentiation. Absolute errors were calculated for each trial. Reliability was assessed using intraclass correlation coefficients (ICC2,k), standard error of measurement, and smallest detectable difference. Bland-Altman plots were used to evaluate agreement. Results: Reliability across all tests and movement directions ranged from good to excellent. Most ICC values exceeded 0.90, with only a small number falling between 0.86 and 0.90. Although differentiation tasks produced larger absolute errors than reproduction tasks, their reliability remained excellent. Bland-Altman analyses demonstrated acceptable bias, reasonable clustering around the mean difference, and only occasional outliers beyond the limits of agreement. Conclusions: The adapted JPS and FS protocols demonstrated high intra- and inter-rater reliability in children with DCD, supporting their use in experimental research.