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Title: | Reproducibility of an instrumented measure for passive ankle dorsiflexion in conscious and anaesthetized children with cerebral palsy. | Authors: | Opie N.L.;Simpson P.;Baker R.;Wolfe R.;Blackburn C.;Rawicki B. ;Graham H.K.;Hastings-Ison T. | Institution: | (Hastings-Ison, Blackburn, Opie, Graham) Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, VIC, Australia (Graham) Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, VIC, Australia (Rawicki) Victorian Paediatric Rehabilitation Service, Monash Children's Hospital, Clayton, VIC, Australia (Wolfe, Simpson) Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Baker) School of Healthcare Science, University of Salford, Salford, United Kingdom | Issue Date: | 24-Mar-2014 | Copyright year: | 2014 | Publisher: | Blackwell Publishing Ltd (9600 Garsington Road, Oxford OX4 2XG, United Kingdom) | Place of publication: | United Kingdom | Publication information: | Developmental Medicine and Child Neurology. 56 (4) (pp 378-385), 2014. Date of Publication: 2014. | Abstract: | Aim: The aims of this study were to (1) determine whether an instrumented measure will reduce measurement error to less than 5degree 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(s): 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. Result(s): The standard error of measurement (SEM) ranged from 3.9degree (anaesthetized; 95% confidence interval [CI] 3.3-4.0degree) to 6.7degree (conscious; 95% CI 5.3-8.0degree). This compared favourably with previously reported dorsiflexion measures (SEM range 6.5-7.8degree) 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(s): 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. © 2013 Mac Keith Press. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1111/dmcn.12276 | Link to associated publication: | Click here for full text options | PubMed URL: | 24102238 [http://www.ncbi.nlm.nih.gov/pubmed/?term=24102238] | ISSN: | 0012-1622 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/41992 | Type: | Article | Subjects: | preschool child priority journal quadriplegia *range of motion reproducibility school child spasticity tertiary health care *passive ankle dorsiflexion male anesthesia *ankle article body weight *cerebral palsy child clinical article consciousness controlled study female Gross Motor Function Classification System hemiplegia human intrarater reliability *leg movement measurement error outcome assessment pediatric hospital photography Gross Motor Function Classification System hemiplegia human intrarater reliability *leg movement male measurement error outcome assessment pediatric hospital photography preschool child priority journal quadriplegia *range of motion reproducibility school child *ankle tertiary health care anesthesia spasticity article body weight *cerebral palsy child clinical article consciousness controlled study female |
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