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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 ±10°. The level of inter-observer agreement was less satisfactory, particularly in hip flexion deformity.