Aim: The purpose of this study was to examine the intra-rater and inter-rater reliability of physiotherapists using the Pirani scoring system for clubfoot to score digital photographs of infants’ feet. Methods: Twelve infant feet were photographed to reflect variations in the six clinical signs of clubfoot. Physiotherapists viewed the photographs and scored the feet using the Pirani scoring system on two separate occasions. Results: Intra-rater reliability was excellent when scoring photographs, while inter-rater reliability was found to be fair to good for most subscales. Experienced therapists demonstrated higher reliability than novice therapists but not significantly so. Reliability was equivalent between the Pirani scoring system and a modified five-point scoring system created for this study. Scoring the rigidity of equinus subscale was found to be more reliable than the other subscales (P<0.01), which did not differ significantly from each other.
This study examines inter-rater reliability between physiotherapists using the Pirani scoring system for clubfoot, and whether the addition of two scale points to give a modified five-point severity scale improves reliability. A total of 65 infant feet were assessed by two raters, with 21 different rater combinations used. The Pirani scoring system was found to be a reliable assessment tool when used by physiotherapists to score clubfoot, with a minimum of fair to good inter-rater reliability demonstrated across all clinical signs. The modified five-point scale proved significantly more reliable than the three-point scale; however, the benefit is not sufficient to warrant varying the original three-point scale.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.