An international consensus study for use of paediatric lower limb neurological impairment tests by physiotherapists

Aim: To gain consensus on factors perceived to influence paediatric lower limb neurological testing. Design: A modified electronic Delphi technique over two sequential survey rounds. Method: An expert panel of experienced paediatric neurological physiotherapy clinicians and academics (n = 34) were invited to participate. Questionnaire 1 was developed using existing literature and open-ended questions. Experts ranked statements via an electronic survey using a 1-6 Likert scale (strongly agree, agree, somewhat agree, somewhat disagree, disagree, strongly disagree). Questionnaire 2 was developed from thematic analysis of the openended questions and sought opinion on statements without consensus. Apriori criteria for consensus was pre-set at 65% agreement/disagreement and median and interquartile range score (25%, 75%) estimated perceived importance. Results: Twenty-six experts from nine countries completed Questionnaire 1, and 24 completed Questionnaire 2. Consensus was reached on 292/316 items (92%). Experts perceived with strong agreement (>85%) and moderate importance (median = agree and interquartile range = somewhat agreestrongly agree) that variations in therapist’s experience, expertise, equipment and time constraints may influence the process and outcomes of a paediatric neurological test. They also perceived with strong agreement and moderate importance that a child’s developmental age, behaviour (including compliance and motivation), cognitive and language abilities could influence neurological testing.