Inter- and intrarater clinician agreement on joint patterns during gait in children with cerebral palsy

AIM This study aimed to quantify the inter- and intrarater agreement with which clinicians can recognize joint patterns during gait in children with spastic cerebral palsy (CP), which were recently specified by a Delphi consensus study1. It also examined whether experience with three-dimensional gait analysis (3DGA) is a prerequisite for using the patterns. METHOD The experimental group consisted of 82 CP patients (57 boys; uni-/bilateral CP (n=27/55); GMFCS I-III; mean age 9 years, 5months). Thirty-two clinical raters were divided in an ‘experienced’ and ‘inexperienced’ rater group. In two classification rounds, each rater was asked to classify 3DGA reports of 27 or 28 patients. Inter- and intrarater agreement on the 49 joint patterns was estimated using percentage of agreement and kappa statistics. RESULTS Twenty-eight raters completed both classification rounds. Intrarater agreement was ‘substantial’ to ‘almost perfect’ for all joints (0.64<ĸ<0.91). Interrater agreement reached similar results (0.63<ĸ