Agreement between a physical therapist and an orthopedic surgeon in children referred for gait abnormalities.

Miller S, Harris SR, Mulpuri K. Agreement between a physical therapist and an orthopedic surgeon in children referred for gait abnormalities. Pediatr Phys Ther. 2016.  DOI: 10.1097/PEP.0000000000000207

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.