Reliability of Clinical Rating Scale in Evaluation of Head Control in children with Cerebral Palsy

Abstract

Introduction The clinical rating scale for head control assesses control of head/neck in children with neurological conditions. Head control is important for activities of daily living and quality of life in children. Objectives The aim of the study was to determine the intra-rater and inter-rater reliability of the scale in children with Cerebral Palsy. Method The study was a cross-sectional study approved by Research ethics committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital involving children with CP. Three independent raters assessed the children using Clinical Rating Scale for Head Control at two different times, and the intra-rater and inter-rater reliabilities were analyzed using kappa statistics and Bland-Altman analysis. Results Fifty children with CP with mean age, 24.17±12.17 months participated in the study. The result of the study showed that there were very good agreement in all the test positions for the three raters and between the first and the second ratings and in all the test positions between the three raters respectively (k>0.8). Similarly, there was no proportional bias between ratings in 24 of the measurements (p>0.05). Conclusion Clinical rating scale for head control seems to be a reliable instrument. Thus, it can be used to monitor the progress of rehabilitation in CP patients to help improve their quality of life.