Agreement Between a Physical Therapist and an Orthopedic Surgeon in Children Referred for Gait Abnormalities. Issue 1 (2016)

• Record Type: Journal Article
• Authors: Miller, Stacey; Harris, Susan R.; Mulpuri, Kishore
• Is Part Of: Pediatric physical therapy. Volume 28:Issue 1(2016:Spring)
• Publication Date: 2016
• Subjects: child -- gait -- musculoskeletal diseases/diagnosis -- musculoskeletal diseases/therapy -- observer variation -- orthopedics -- physical therapy specialty -- primary care physicians; Physical therapy for children -- Periodicals; 615.820832
• DOI: 10.1097/PEP.0000000000000207
• Languages: English
• ISSNs: 0898-5669

Abstract

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. Abstract : This study provides support for the role of PTs not only in triaging patients with variants of gait for a pediatric orthopedic surgeon but also as first-contact, primary diagnosticians of gait deviations.