title: Reliability and validity of the range of motion scale (ROMS) in patients with abnormal postures.
abstract: OBJECTIVE
  Sustained abnormal postures (i.e., fixed dystonia) are the most frequently reported motor abnormalities in complex regional pain syndrome (CRPS), but these symptoms may also develop after peripheral trauma without CRPS. Currently, there is no valid and reliable measurement instrument available to measure the severity and distribution of these postures. The range of motion scale (ROMS) was therefore developed to assess the severity based on the possible active range of motion of all joints (arms, legs, trunk, and neck), and the present study evaluates its reliability and validity.
  
  
  METHODS
  Inter- and intra-rater reliability of the ROMS was determined in 16 patients with abnormal sustained postures, who were videotaped following a standard video protocol in a university hospital. The recordings were rated by a panel of international experts. In addition, 30 patients were clinically tested with both the Burke-Fahn-Marsden (BFM) scale as well as the ROMS to assess construct validity.
  
  
  RESULTS
  Inter-rater reliability for total ROMS scores showed an intra-class correlation coefficient (ICC) of 0.85. The majority of the scores for the separate joints (13 out of 18) demonstrated an almost perfect agreement with ICCs ranging from 0.81 to 0.94; of the other items, one showed fair, one moderate, and three substantial agreement. The ICCs for the intra-rater reliability ranged from moderate to almost perfect (0.68-0.98). Spearman's correlation coefficients between corresponding body areas as measured with the ROMS or BFM were all above 0.82.
  
  
  CONCLUSIONS
  The ROMS is a reliable and valid instrument to evaluate the severity and distribution of sustained abnormal postures.
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Diana E
authors.initials: DE
authors.lastname: van Rooijen
authors.forename: Stefania
authors.initials: S
authors.lastname: Lalli
authors.forename: Johan
authors.initials: J
authors.lastname: Marinus
authors.forename: Christian
authors.initials: C
authors.lastname: Maihöfner
authors.forename: Candida S
authors.initials: CS
authors.lastname: McCabe
authors.forename: Alex G
authors.initials: AG
authors.lastname: Munts
authors.forename: Anton A
authors.initials: AA
authors.lastname: van der Plas
authors.forename: Marina A J
authors.initials: MA
authors.lastname: Tijssen
authors.forename: Bart P
authors.initials: BP
authors.lastname: van de Warrenburg
authors.forename: Alberto
authors.initials: A
authors.lastname: Albanese
authors.forename: Jacobus J
authors.initials: JJ
authors.lastname: van Hilten
mesh_terms: D000328:Adult; D004421:Dystonia / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009460:Neurologic Examination / Q000379:methods / Q000592:standards*; D010865:Pilot Projects; D011187:Posture / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Abnormal Postures; Active Range of Motion; Complex Regional Pain Syndrome; Rating Scale; Reliability; Validity