Original Article

Influence of clinical experience and instruction on typical cases on the inter-rater reliability of observational gait analysis

Hiroki Tanikawa, RPT, DMSc, Kei Ohtsuka, RPT, DMSc, Junya Yamada, RPT, MS, Masahiko Mukaino, MD, DMSc, Fumihiro Matsuda, RPT, DMSc, Hitoshi Kagaya, MD, DMSc, Eiichi Saitoh, MD, DMSc, Yoshikiyo Kanada, RPT, DMSc, Shuji Hashimoto, DMSc
Jpn J Compr Rehabil Sci 10: 14-20, 2019

Objective: To investigate the influence of clinical experience and instruction by observing typical cases beforehand on the inter-rater reliability of observational gait analysis.
Methods: Thirty physical therapists were divided into the instructed group and the non-instructed group. Each group was then divided into two subgroups according to clinical experience. All the groups viewed videos of 30 hemiplegic patients walking on a treadmill, and then rated the severity of abnormalities on a scale of five levels. The agreement of judgments was calculated. The instructed group viewed videos of typical cases for each severity before the rating.
Results: Agreement between raters was low in the non-instructed group and slightly higher in the instructed group. Almost all pairs of raters had a significant rank correlation. The proportion of pairs with a significant rank correlation of the rating as well as no significant difference in the ratings according to the Wilcoxon signed-rank test was larger in the instructed group than in the non-instructed group.
Conclusions: The reliability of observational judgments was low even among experienced raters. This was due to the difference in the ratersf subjective scale. Observation of typical cases is effective for improving the reliability.

Key words: observational gait analysis, hemiplegia, reliability, clinical experience, instruction

Contents (volume 10)