Article

OBJECTIVE: To measure the Tardieu Scale's reliability in children with cerebral
palsy (CP) when used by raters with and without experience in using the scale,
before and after training. DESIGN: Single-center, intrarater and interrater
reliability study. SETTING: Institutional ambulatory care. PARTICIPANTS: Referred
children with CP in the pretraining phase (n=5), during training (n=3), and in
the posttraining phase (n=15). INTERVENTIONS: The Tardieu Scale involves
performing passive muscle stretch at 2 velocities, slow and fast. The rater
derives 2 parameters; the Spasticity Angle X is the difference between the angles
of arrest at slow speed and of catch-and-release or clonus at fast speed; the
Spasticity Grade Y is an ordinal variable that grades the intensity (gain) of the
muscle reaction to fast stretch. In phase 1, experienced raters without
formalized training in the scale graded elbow, knee, and ankle plantar flexors
bilaterally, without and with a goniometer. In phase 2, after training, the
experienced and nonexperienced raters graded the same muscles unilaterally. MAIN
OUTCOME MEASURES: Intrarater and interrater reliability of the Tardieu Scale.
RESULTS: After training, nonexperienced raters had mean +/- SD intrarater and
interrater agreement rates across all joints and parameters of 80%+/-14% and
74%+/-16%, respectively. For experienced raters, intrarater and interrater
agreement rates before training were 77%+/-13% and 66%+/-15%, respectively,
versus 90%+/-8% and 81%+/-13%, respectively, after training (P<.001 for both).
Specific angle measurements at the knee were less reliable for the angles of
catch measured at fast speed. Across all joints, agreement rates were similar
using visual or goniometric measurements. CONCLUSIONS: Both parameters of the
Tardieu Scale have excellent intrarater and interrater reliability when assessed
at the elbow and ankle joints of children with CP, with no difference noted
between visual and goniometric measurements. Angle measurements were less
reliable at the knee joints. Training was associated with a highly significant
improvement in reliability.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS