Seung Yeol Lee1, Ki Hyuk Sung2, Chin Youb Chung3, Kyoung Min Lee3, Soon-Sun Kwon4, Tae Gyun Kim5, Sang Hyeong Lee6, In Hyeok Lee7, Moon Seok Park3. 1. Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea. 2. Department of Orthopaedic Surgery, Myongji Hospital, Kyungki, Korea. 3. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Kyungki, Korea. 4. Biomedical Research Institute, Seoul National University Bundang Hospital, Kyungki, Korea. 5. Department of Orthopaedic Surgery, Konyang University Hospital, Daejon, Korea. 6. Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Kyungki, Korea. 7. Department of Orthopaedic Surgery, Sungkyunkwan University Samsung Changwon Hospital, Gyeongnam, Korea.
Abstract
AIM: The aim of this study was to clarify the method of the Duncan-Ely test and to estimate its interobserver reliability and validity by comparing it with three-dimensional gait analysis (3DGA). METHOD: This study included 36 consecutive ambulatory patients with cerebral palsy (CP) who underwent preoperative 3DGA. The Duncan-Ely test was performed during three different velocities (slow, gravity, and fast). The interobserver reliability was assessed by three examiners. The results of the test were compared with kinematic variables derived from the gait analysis to assess the sensitivity and specificity of the test. The cut-off value was determined at the point of trade-off between the highest sensitivity and specificity. RESULTS: The intraclass correlation coefficient measuring interobserver reliability of the Duncan-Ely test was greatest during fast velocity (0.819). The sensitivity and specificity of the test during gravity velocity for knee range of motion total were 63.0% and 100% respectively, with a cut-off value of 78.3°. The sensitivity and specificity of the test during fast velocity for knee range of motion total were 66.7% and 100% respectively, with a cut-off value of 65°. INTERPRETATION: The Duncan-Ely test shows excellent reliability in fast knee-flexion velocity, and good sensitivity and specificity compared with 3DGA during physical examination as a preoperative assessment of rectus femoris spasticity in patients with CP.
AIM: The aim of this study was to clarify the method of the Duncan-Ely test and to estimate its interobserver reliability and validity by comparing it with three-dimensional gait analysis (3DGA). METHOD: This study included 36 consecutive ambulatory patients with cerebral palsy (CP) who underwent preoperative 3DGA. The Duncan-Ely test was performed during three different velocities (slow, gravity, and fast). The interobserver reliability was assessed by three examiners. The results of the test were compared with kinematic variables derived from the gait analysis to assess the sensitivity and specificity of the test. The cut-off value was determined at the point of trade-off between the highest sensitivity and specificity. RESULTS: The intraclass correlation coefficient measuring interobserver reliability of the Duncan-Ely test was greatest during fast velocity (0.819). The sensitivity and specificity of the test during gravity velocity for knee range of motion total were 63.0% and 100% respectively, with a cut-off value of 78.3°. The sensitivity and specificity of the test during fast velocity for knee range of motion total were 66.7% and 100% respectively, with a cut-off value of 65°. INTERPRETATION: The Duncan-Ely test shows excellent reliability in fast knee-flexion velocity, and good sensitivity and specificity compared with 3DGA during physical examination as a preoperative assessment of rectus femoris spasticity in patients with CP.
Authors: Martin J B Tenniglo; Marc J Nederhand; Judith F Fleuren; Johan S Rietman; Jaap H Buurke; Erik C Prinsen Journal: J Rehabil Med Date: 2022-01-03 Impact factor: 3.959