Concordance Between a Physical Therapist and a Pediatric Orthopedic Surgeon

Stacey Miller

Purpose: To compare the diagnosis obtained and care recommended by a pediatric physiotherapist (PT) and orthopedic surgeon for children referred to the surgeon for variants of typical development of the lower extremity.

Methods: Twenty-five children referred to the orthopaedic surgeon were independently assessed by a pediatric PT and orthopaedic surgeon. Each made conclusions regarding diagnosis, treatment, and follow-up requirements. Agreement was then calculated using the kappa statistic.

Findings: The results suggest that a PT and orthopaedic surgeon have substantial to excellent diagnostic concordance and moderate concordance for treatment and follow up recommendations for children referred with variants of typical gait. Differences were unimportant and did not affect patient management.

Conclusion: This study suggests that a pediatric PT and orthopedic surgeon make similar decisions regarding the management of children referred for gait abnormalities and provides support for the role of a PT triaging these children for an orthopaedic surgeon.

Accepted for publication:

Miller, S., Harris, S. R., & Mulpuri, K. (2016). Agreement between a physical therapist and an orthopedic surgeon in children referred for gait abnormalities. Pediatric Physical Therapy, 28(1), 85–92.