Inter-rater reliability of physiotherapists using the Pirani scoring system for clubfoot

Comparison with a modified five-point scale

Nicole J. Harvey, Anita J. Mudge, Deborah T. Daley, Susan K. Sims, Roger D. Adams

Research output: Contribution to journalArticle

6 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)493-500
Number of pages8
JournalJournal of Pediatric Orthopaedics Part B
Issue number6
Publication statusPublished - Nov 2014
Externally publishedYes


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