The reliability, responsiveness and clinical utility of the Proximat: a new tool for measuring hip range of movement in children with cerebral palsy.
OBJECTIVE
Monitoring range of movement is a key aspect of managing hip problems in children with cerebral palsy. The aim of this study was to assess the clinical utility, reliability and responsiveness of a new measurement tool, the Proximat, for hip range of movement.


METHODS
Passive hip abduction, adduction, medial and lateral rotation were measured by using the Proximat on 26 children with cerebral palsy attending three special schools: 16 of whom are boys, mean age = 7 years and 6 months (standard deviation = 4.2 years), range 2-15 years. Testing was undertaken by two physiotherapists to assess interrater reliability and repeated the following day to assess test-retest reliability. Total, random and systematic errors were calculated for interrater and test-retest.


RESULTS
The Proximat was quick and easy to use and acceptable to the children. High reliability was found for all movements (intraclass correlation coefficient = 0.83-0.93) with reasonable responsiveness; total error was 2.5-12 degrees. Most of the error was random with little evidence of systematic bias.


CONCLUSIONS
The Proximat is a reliable, responsive and acceptable method of measuring passive hip movements in children with cerebral palsy in day-to-day clinical practice. A change of 8-12 degrees is needed to overcome measurement error and to indicate that a 'true' change in range of movement has occurred.
Pott
Patricia
P
Lancasterian School, Manchester Primary Care Trust, Manchester, UK.
Selley
Andrea
A
Tyson
Sarah F
SF
D053587:Arthrometry, Articular / Q000295:instrumentation* / Q000379:methods; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D005260:Female; D006621:Hip Joint / Q000503:physiopathology*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D015203:Reproducibility of Results