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 ratersf subjective
scale. Observation of typical cases is effective for
improving the reliability.
Key words: observational gait analysis, hemiplegia, reliability, clinical experience, instruction