The intra- and inter-rater reliability of the Goldsmith indices of body symmetry in non-ambulant adults with cerebral palsy

Abstract

Purpose

Non-ambulant adults with cerebral palsy are at risk of developing asymmetry affecting thoracic cage, pelvis and hips. The primary aim of this study was to establish intra-rater and inter-rater reliability of the Goldsmith Indices of Body Symmetry in non-ambulant adults with cerebral palsy. The secondary aim was to establish comparative data for the Goldsmith Indices of Body Symmetry in healthy adults.

Materials and method

Thirty non-ambulant young adults with cerebral palsy (17 males), and 48 young healthy controls (19 males), were recruited. Thoracic shape and symmetry, pelvic orientation and hip range, was measured using the Goldsmith Indices of Body Symmetry. Intra-rater reliability was established by repeated measurement within a single session. Inter-rater reliability was established having two raters measure each participant on two sequential sessions. Analysis utilised intraclass correlation coefficients.

Results

The Goldsmith Indices of Body Symmetry has excellent intra-rater reliability (intraclass correlation coefficients ≥0.97). Inter-rater reliability for all Goldsmith Indices of Body Symmetry measures was good to excellent (intraclass correlation coefficients ≥0.85). Range and variability of results was greater for participants with cerebral palsy compared to comparative data.

Conclusion

The Goldsmith Indices of Body Symmetry has good inter and intra-rater reliability for measurement of thoracic shape and symmetry, pelvic orientation and hip range, allowing accurate tracking of postural changes over time in non-ambulant adults with cerebral palsy.

Implications for rehabilitation

• The Goldsmith Indices of Body Symmetry is a reliable clinical measurement tool to enable measurement of the thoracic shape and symmetry, pelvic and hip orientation in adults with cerebral palsy.

• The Goldsmith Indices of Body Symmetry, with an impairment focus, is a useful adjunct to the assessment and management of postural asymmetry in adults with cerebral palsy.

Keywords:

• Cerebral palsy
• clinical measurement
• reliability
• thorax
• hips
• pelvis
• windswept

Acknowledgements

The authorship team would like to acknowledge the contribution of Professor Sue Cotton to statistical methodology and to St. Vincent’s Hospital Young Adult Complex Disability Clinic clinicians and management for their ongoing support.

Disclosure statement

No potential conflict of interest was reported by the authors.