The static examination of children and young adults with cerebral palsy in the gait analysis laboratory: technique and observer agreement

The assessment of ambulant children with spastic cerebral palsy frequently includes an evaluation in the motion analysis laboratory, consisting of a standardized physical examination and instrumented gait analysis. We therefore designed a repeatability study to evaluate observer agreement of five joint range of motion parameters, in 20 patients with cerebral palsy aged 5-25 years. These five parameters are some of the most important measurements made during the static examination in the gait laboratory. Intra-observer agreement was high (concordance correlation coefficient range, 0.67 -0.96), and using Bland and Altman analysis it was clinically acceptable with 95% limits of agreement of all parameters close to within +/- 10degrees. The level of inter-observer agreement was less satisfactory, particularly in hip flexion deformity.