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Background: One of the skeletal abnormalities frequently found in children with cerebral palsy (CP) is increased femoral neck anteversion (FNA). During clinical examination, FNA can be estimated in children with CP if passive range of motion (ROM) of internal and external hip rotation is measured, observed and compared, as well as by using the Trochanteric Prominent Angle Test (TPAT). The aim of the study was to assess reliability of the two methods for estimating FNA during clinical examination in children with CP. Methods: The participants were children with CP treated as outpatients or in-patients at the children's department of the University Rehabilitation Institute in Ljubljana between December 2009 and June 2010. Four series of measurements were performed with each child by four physiotherapists. Each series included goniometric measurement of passive ROM of internal and external hip rotation, followed by three consecutive measurements of FNA angle using the TPAT on both lower limbs. Results: Thirty-one children participated, 14 boys and 17 girls, aged 9 years on average. All the intra-class correlation coefficients, which were used for assessing intra- andinter-rater reliability of FNA angle measurement and passive ROM of internal and external hip rotation on the right and left side, were high (0.7 to 0.9). Conclusion: The results show that the methods for determining FNA angle during clinical examination in the addressed population are reliable. Hence, they are suitable and useful for clinical practice within rehabilitation. Izhodišča: Ena od pogostih skeletnih nepravilnosti pri otrocih s cerebralno paralizo (CP) je povečana anteverzija vratu stegnenice (AVS). Med kliničnim pregledom lahko AVS pri otrocih s CP ocenimo, če merimo, opazujemo in primerjamo pasivne obsege gibov notranje in zunanje rotacije v kolkih, in s pomočjo kliničnega testa za merjenje kota anteverzije vratu stegnenice (angl. Trochanteric Prominent Angle Test - TPAT). Naš namen je bil oceniti zanesljivost obeh metod za določanje AVS med kliničnim pregledom pri otrocih s CP. Metode: V študijo smo vključili otroke s CP, ki so bili vključeni v ambulantno ali bolnišnično rehabilitacijsko obravnavo na otroškem oddelku URI-Soča med decembrom 2009 in junijem 2010. Pri vsakem od otrok smo opravili štiri serije meritev, ki so jih izvajale štiri fizioterapevtke. Vsaka serija je vključevala goniometrično meritev pasivnega obsega giba notranje in zunanje rotacije v kolku ter tri zaporedne meritve kota AVS z metodo TPAT na obeh spodnjih udih. Rezultati: V raziskavi je sodelovalo 31 otrok, 14 dečkov in 17 deklic, povprečno starih devet let. Vsi intraklasni korelacijski koeficienti, ki smo jih uporabili za oceno zanesljivosti preiskovalca in oceno zanesljivosti med preiskovalci za merjene kota AVS ter pasivnega obsega giba notranje in zunanje rotacije levo in desno, so bili visoki (0,7 do 0,9). Zaključki: Rezultati kažejo, da sta metodi za določanje kota AVS med kliničnim pregledom pri izbrani populaciji bolnikov zanesljivi. Kot taki sta primerni in uporabni v klinični praksi v procesu rehabilitacije. |
