Abstract
ABSTRACTAims: Examine the inter-rater reliability of the Daniels and Worthingham (D&W) manual muscle test (MMT) protocol for children with spina bifida between experienced and novice physiotherapists. Methods: Thirteen children with spina bifida (two males) aged 6 to 18 years were recruited from a spina bifida service in a state-wide tertiary children's hospital. Each child had the muscle strength of 19, and lower limb muscles were measured bilaterally by one experienced and one novice physiotherapist using the D&W MMT protocol. Examiner and limb order were counterbalanced. Standard training and recording sheets were used. Agreement between raters was examined with quadratic weighted kappa (κw2), percentage exact agreement (%EA), and the Bland–Altmann Limits of Agreement (LoA). Minimal detectable change (MDC) was calculated. Results: Inter-rater agreement between the experienced and novice raters was excellent (κw2 = 0.95; 95% confidence interval: 0.94–0.96); %EA was good (72.3%); and clinically appropriate LoA levels were −1.30–1.40. The MDC was 1.11 points on a six-point MMT scale. Conclusions: The D&W MMT protocol, when used after standard training and with standard recording sheets, was reproducible for children with spina bifida, aged 6–18 years.
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