Article,

Test-retest reliability of isokinetic dynamometry for the assessment of spasticity of the knee flexors and knee extensors in children with cerebral palsy.

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Arch Phys Med Rehabil, 87 (5): 697--702 (May 2006)
DOI: 10.1016/j.apmr.2006.01.020

Abstract

OBJECTIVE: To assess test-retest reliability of the peak resistance torque and slope of work methods of spasticity measurement of the knee flexors and extensors in children with cerebral palsy (CP). DESIGN: Test-retest reliability study. SETTING: Pediatric orthopedic hospital. PARTICIPANTS: Fifteen children with CP. INTERVENTION: Knee extensor and flexor spasticity was assessed with an isokinetic dynamometer using passive movements at 15 degrees, 90 degrees, and 180 degrees/s taken 1 hour apart. MAIN OUTCOME MEASURES: Peak resistive torque and work were calculated. The relative and absolute test-retest reliability was calculated by using intraclass correlation coefficients (ICCs) and Bland-Altman plots, respectively. RESULTS: Relative reliability was good (ICC>.75) for slope-of-work and peak resistance torque measurements at a velocity of 180 degrees/s, whereas reliability of peak torque measurements was decreased (ICC<.51) at slower velocities for both muscle groups. The 95\% limits of agreement of Bland-Altman plots contained most data points for both methods, but the width of the limits of agreement were wide. CONCLUSIONS: The measurement of spasticity of the knee extensors and flexors in children with CP using peak-resistance torque at 180 degrees/s and the slope of work method has acceptable relative test-retest reliability. However, the absolute reliability of spasticity data should be considered cautiously.

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