Reliability of the Clinical Measurement of Upper and Lower Extremity Joint Motion in the Pediatric Population: A Systematic Review.

Aim: To examine intraobserver and interobserver reliability of the clinical measurement of pediatric joint motion of upper and lower extremities, based on participant condition and measurement technique.

Methods: PubMed, CINAHL, and Web of Science were searched using combinations of children or adolescents, range of motion, and reliability. Reference lists and citations of reviewed studies were searched for additional publications.

Results: Thirty-one studies of pediatric samples of developing typically, orthopedic injuries, athletes, cerebral palsy, and other diagnoses were reviewed. For techniques, measurements were made most frequently with a goniometer followed by visual estimation, inclinometer, smartphone apps, and specialized devices. The reliability of hip abduction measurements of participants with cerebral palsy was evaluated most often and varied widely for both intraobserver and interobserver. In general, goniometric results indicated greater reliability for upper than lower extremities and for intraobserver than interobserver. As the other techniques were each utilized in only a few studies, involving different participant conditions, joint motions and statistics, the analysis of their reliability was limited.

Conclusions: Intraobserver and interobserver reliability have not been established for pediatric joint motion measurements. Further research should include various joint motion measurements for different pediatric conditions using appropriate statistics. Results would provide important information for making clinical decisions.