Intraobserver reliability of static measures in the normally developing infant foot and clubfoot

Gelfer, Yael; Durham, Sally; Daly, Karen; Ewins, D. J.

doi:10.1097/bpb.0b013e32832c2f7d

Cited by 8 publications

(7 citation statements)

References 16 publications

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“… 23 commented on problem of, lack in intra- and inter-observer consistency in classification systems owning to subjective nature of these classifications and despite the lack of reliable data, surgeons have been using them regularly as a dependent measure. 23 24 …”

Section: Discussionmentioning

confidence: 99%

Interobserver variability in Pirani clubfoot severity scoring system between the orthopedic surgeons

Jain

Ajmera

Solanki

et al. 2017

IJOO

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Background:Congenital talipes equinovarus (clubfoot) is one of the most common congenital pediatric orthopedic foot deformity, which varies in severity and clinical course. Assessment of severity of the club foot deformity is essential to assess the initial severity of deformity, to monitor the progress of treatment, to prognosticate, and to identify early relapse. Pirani's scoring system is most acceptable and popular for club foot deformity assessment because it is simple, quick, cost effective, and easy. Since the scoring system is subjective in nature it has inter- and intra-observer variability, it is widely used. Hence, the interobserver variability between orthopedic surgeons in assessing the club foot severity by Pirani scoring system.Materials and Methods:We assessed the interobserver variability between five orthopedic surgeons of comparable skills, in assessing the club foot severity by Pirani scoring system in 80 feet of 60 children (20 bilateral and 40 unilateral) with club foot deformity. All the five different orthopedic surgeons were familiar with Pirani clubfoot severity scoring and Ponseti cast manipulation, as they had already worked in CTEV clinics for at least 2 months. Each of them independently scored, each foot as per the Pirani clubfoot scoring system and recorded total score (TS), Midfoot score (MFS), Hind foot score (HFS), posterior crease (PC), emptiness of heel (EH), rigidity of equnius (RE), medial crease (MC), curvature of lateral border (CLB), and lateral head of talus (LHT). Interobserver variability was calculated using kappa statistic for each of these signs and was judged as poor (0.00–0.20), fair (0.21–0.40), moderate (0.41–0.60), substantial (0.61–0.80), or almost perfect (0.81–1.00).Results:The mean age was 137 days (range 21-335) days. The mean Pirani score was 3.86. We found the overall consistency to be substantial for overall score (total score kappa - 0.71) and also for midfoot (0.68) and hindfoot (0.66) separately. The consistency was least for the emptiness of heel (kappa - 0.39), and best for rigidity of equnius (kappa - 0.68) and rest of the parameters were moderate (kappa between 0.40 and 0.60).Conclusion:The Pirani scoring system had got substantial reliability in assessing the clubfoot deformity even when the reliability test was extended to five different orthopedic surgeons simultaneously.

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Section: Discussionmentioning

confidence: 99%

Interobserver variability in Pirani clubfoot severity scoring system between the orthopedic surgeons

Jain

Ajmera

Solanki

et al. 2017

IJOO

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“…The two examiners then assessed the foot using the Pirani severity score [19]. Measures of ankle ROM into dorsiflexion with knee flexed (ADKF) and extended (ADKE), and calf circumference (CC), were also taken following a protocol developed by Gelfer et al [20]. Goniometric measures of eversion range were not considered to be reliable so were not collected.…”

Section: Methodsmentioning

confidence: 99%

The effect of neuromuscular electrical stimulation on congenital talipes equinovarus following correction with the Ponseti method: a pilot study

Gelfer¹,

Durham

Daly

et al. 2010

Journal of Pediatric Orthopaedics B

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The Ponseti method for clubfoot treatment offers satisfactory initial correction, but success correlates with abduction brace compliance, which is variable. Electrical stimulation as a dynamic intervention to prevent relapses was investigated. Data were compared to a control group. There was a significant improvement in ankle range of motion only in the study group after short-term intervention, and a trend toward greater increase in calf circumference in this group. Parental perception was positive with no compliance issues. This study suggests stimulation is feasible with potential to increase ankle range of motion and facilitate muscle activity. It could be an important adjunct in preventing relapses, however, further studies with larger groups and longer intervention and follow-up duration are necessary.

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“…32 Therefore it is expected that children with clubfoot are likely to produce more reliable results. foot type between healthy and affected children has also been raised in previous reliability studies.…”

Section: Discussionmentioning

confidence: 99%

Interventions for congenital talipes equinovarus

Gray

Pacey

Gibbons

et al. 2010

Cochrane Database of Systematic Reviews

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Intraobserver reliability of static measures in the normally developing infant foot and clubfoot

Cited by 8 publications

References 16 publications

Interobserver variability in Pirani clubfoot severity scoring system between the orthopedic surgeons

Interobserver variability in Pirani clubfoot severity scoring system between the orthopedic surgeons

The effect of neuromuscular electrical stimulation on congenital talipes equinovarus following correction with the Ponseti method: a pilot study

Interventions for congenital talipes equinovarus

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