Article

The aims of this study were to (1) determine whether an instrumented measure
will reduce measurement error to less than 5 degrees in children with cerebral
palsy (CP), (2) determine agreement and reliability of this instrumented measure
in both conscious and anaesthetized participants, and (3) compare the method with
previously reported measures. METHOD: Thirty-four ambulant children (15 males, 19
females), aged 3 to 9 years, with spastic CP were studied in a tertiary-care
paediatric hospital (21 with hemiplegia, 11 with diplegia, and two with
quadriplegia). The majority of children functioned at Gross Motor Function
Classification System level I (n=11) or II (n=18), with five children at level
III. Ankle dorsiflexion at 50% bodyweight was photographed and measured. Each
child was measured when conscious and when under mask anaesthesia by two
experienced assessors. RESULTS: The standard error of measurement (SEM) ranged
from 3.9 degrees (anaesthetized; 95% confidence interval [CI] 3.3-4.0 degrees )
to 6.7 degrees (conscious; 95% CI 5.3-8.0 degrees ). This compared favourably
with previously reported dorsiflexion measures (SEM range 6.5-7.8 degrees ) in
conscious children with CP. Intrarater reliability was good in both conditions
(intraclass correlation coefficient [ICC]: range 0.95 [anaesthetized; 95% CI
0.92-0.98] to 0.86 [conscious; 95% CI 0.76-0.95]). The ICC for interrater
reliability ranged from 0.87 (anaesthetized; 95% CI 0.81-0.93) to 0.65
(conscious; 95% CI 0.50-0.81). INTERPRETATION: Passive ankle dorsiflexion using
an instrumented measure has face validity and may assist in the improvement of
reproducibility under anaesthesia for clinical research. When an individual is
conscious, this technique is not better than trained assessors using conventional
goniometry reported in the literature and is not recommended for routine clinical
use.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS