INTRAOBSERVER AND INTEROBSERVER RELIABILITIES OF THE LOWER EXTREMITY RANGE OF ARTICULAR MOTION IN CEREBRAL PALSY: LE MÉTAYER METHOD

Abstract

 The objective of this study was to verify if divergences appear and their magnitude in the articular valuation of cerebral paralytics using Le Métayer's methodology. This proposal had its origin after several publications appeared showing divergences of up to 30º in these valuations. The free passive range of motion was valued in a sample of 7 boys and 13 girls, 10 of them with cerebral paralysis of the hemiplegia, diplegia or tetraplegia type. Their ages varied from 4 to 19 years with an average of 12 years and 8 months. Two physical therapists successively evaluated the subjects' lower limb, repeating each measurement twice in the same day to calculate the reliability intra and interobserver.  Ranges of motion valued, and muscles put in tension respectively were ankle flexion (soleus), knee extension (is-quiotibialis), hip abduction (adductors) and knee flexion (quadriceps). Some of our results were: interobserver reliability was confirmed for the 4 articular valuations. Knee flexion was also reliable between observers. Lack of interobserver reliability for hip abduction and knee extension was justified as caused by valuator's mistakes in methodology´s application, whereas that for ankle flexion proved that a short training is needed. one the 4 articular valuations showed cerebral paralysis was related to reliablility for the same or different observers. All this leads us to conclude that Le Métayer's methodology improves reliability in lower limb goniometry especially when neuromotor alterations exist.