Stacey Miller1, Susan R Harris, Kishore Mulpuri. 1. Orthopaedic Department (Ms Miller and Dr Mulpuri), British Columbia Children's Hospital, Vancouver, British Columbia, Canada; Department of Physical Therapy (Dr Harris), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
PURPOSE: To compare diagnostic and treatment agreement between a physical therapist (PT) and a pediatric orthopedic surgeon for gait variations in children. METHODS: This pilot study involved children referred to a pediatric orthopedic surgeon for typical gait variations. A PT and an orthopedic surgeon individually assessed each child, making conclusions regarding diagnoses, treatment, and follow-up. Agreement was determined using κ values. RESULTS: Twenty-five children (9 months to 11 years) were assessed. The PT and the surgeon had substantial agreement on contributors to the atypical gait patterns (76% agreement; κ = 0.67; 95% confidence interval [CI] = 0.45-0.90) and almost perfect agreement on underlying diagnosis of gait variation (93% agreement; κ = 0.89; 95% CI = 0.75-1.0), with substantial agreement for treatment (82% agreement; κ = 0.72; 95% CI = 0.47-0.97) and follow-up recommendations (84% agreement; κ = 0.63; 95% CI = 0.24-1.0). CONCLUSIONS: A pediatric PT and an orthopedic surgeon had substantial to almost perfect agreement for diagnoses, treatment, and follow-up in children referred for gait abnormalities.
PURPOSE: To compare diagnostic and treatment agreement between a physical therapist (PT) and a pediatric orthopedic surgeon for gait variations in children. METHODS: This pilot study involved children referred to a pediatric orthopedic surgeon for typical gait variations. A PT and an orthopedic surgeon individually assessed each child, making conclusions regarding diagnoses, treatment, and follow-up. Agreement was determined using κ values. RESULTS: Twenty-five children (9 months to 11 years) were assessed. The PT and the surgeon had substantial agreement on contributors to the atypical gait patterns (76% agreement; κ = 0.67; 95% confidence interval [CI] = 0.45-0.90) and almost perfect agreement on underlying diagnosis of gait variation (93% agreement; κ = 0.89; 95% CI = 0.75-1.0), with substantial agreement for treatment (82% agreement; κ = 0.72; 95% CI = 0.47-0.97) and follow-up recommendations (84% agreement; κ = 0.63; 95% CI = 0.24-1.0). CONCLUSIONS: A pediatric PT and an orthopedic surgeon had substantial to almost perfect agreement for diagnoses, treatment, and follow-up in children referred for gait abnormalities.