Reliability among Physical Therapists in Diagnosis and Treatment of Gait Deviations in Hemiplegics

Abstract

A questionnaire study and an observational study were conducted to investigate reliability among physical therapists in diagnosing and treating gait deviations in hemiplegics. In Study 1, groups of 3 therapists independently filled out questionnaires on each of 10 patients to determine the extent to which therapists agree on deviations to be treated and on treatment approach. In Study 2, raters observed gait training classes and independently scored the frequency of a variety of ongoing therapist responses and the frequency of specified gait deviations being treated in the patients. The aims of this study were to determine whether observers agreed on frequencies of therapist and patient responses, to assess quantitatively whether different therapists differ in their treatment approaches, and to determine whether some of the observed therapists produce greater changes in frequency of gait deviations than others. The results of Study 1 suggested rather poor agreement among therapists as to the major gait deviations to be treated and the preferred approaches to treatment of the individuals observed. Study 2 indicated high agreement among raters scoring both therapist and patient responses and suggested differences in observed treatment approaches and differences in degree of change produced by different therapists. Results, observations, and the need for further research were discussed.