Are paediatric lower limb neurological tests clinimetrically sound? A systematic review

Abstract

Questions: Do clinimetrically-sound lower limb neurological examinations exist for paediatric individuals aged under 18 years with a neurological condition? Design: Systematic review with clinimetric properties from studies critically appraised and synthesised. Participants: Primary studies focussed on the clinimetric evaluation of lower limb neurological tests for muscle strength, sensation, or reflexes for children and young people with a neurological condition. Outcome Measures: The methodological quality of each primary study was rated from poor to excellent using a critical appraisal tool. Clinimetric properties for each neurological test were then synthesised. Results: Eight clinimetric studies were identified. All evaluated the reliability of lower limb muscle strength. Strength, however, was evaluated using a variety of different tests. The quality of these studies was rated as fair to good and variable reliability was found. Hand-held dynamometer had the greatest volume of evidence in children and young people with cerebral palsy. However, the evidence appeared too variable to support its use. Conclusion: The limited clinimetric properties found for lower limb muscle strength tests in children with a neurological condition demonstrates that additional high quality research is required for neurological examinations of the lower limb in paediatric individuals with a neurological condition.