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Reliability and validity of the range of motion scale (roms) in patients with abnormal postures

van Hilten, Jacobus J.; van de Warrenburg, Bart P.; Tijssen, Marina A.J.; van der Plas, Anton A.; Munts, Alex G.; Mccabe, Candida S.; Maih�fner, Christian; van Rooijen, Diana E.; van Rooijen, Diana; Lalli, Stefania; Marinus, Johan; Maihofner, Christian; McCabe, Candy; van der Plas, Anton; Munts, Alex; Tijssen, Maina; van de Warrenburg, Bart; Albanese, Alberto; van Hilten, Jacobus


Jacobus J. van Hilten

Bart P. van de Warrenburg

Marina A.J. Tijssen

Anton A. van der Plas

Alex G. Munts

Candida S. Mccabe

Christian Maih�fner

Diana E. van Rooijen

Diana van Rooijen

Stefania Lalli

Johan Marinus

Christian Maihofner

Candy McCabe
Professor of Clinical Research and Practice

Anton van der Plas

Alex Munts

Maina Tijssen

Bart van de Warrenburg

Alberto Albanese

Jacobus van Hilten


© 2015 American Academy of Pain Medicine. Objective: Sustained abnormal postures (i.e., fixed dystonia) are the most frequently reported motor abnormalities in complex regional pain syndrome (CRPS), but these symptoms may also develop after peripheral trauma without CRPS. Currently, there is no valid and reliable measurement instrument available to measure the severity and distribution of these postures. The range of motion scale (ROMS) was therefore developed to assess the severity based on the possible active range of motion of all joints (arms, legs, trunk, and neck), and the present study evaluates its reliability and validity. Methods: Inter- and intra-rater reliability of the ROMS was determined in 16 patients with abnormal sustained postures, who were videotaped following a standard video protocol in a university hospital. The recordings were rated by a panel of international experts. In addition, 30 patients were clinically tested with both the Burke-Fahn-Marsden (BFM) scale as well as the ROMS to assess construct validity. Results: Inter-rater reliability for total ROMS scores showed an intra-class correlation coefficient (ICC) of 0.85. The majority of the scores for the separate joints (13 out of 18) demonstrated an almost perfect agreement with ICCs ranging from 0.81 to 0.94; of the other items, one showed fair, one moderate, and three substantial agreement. The ICCs for the intra-rater reliability ranged from moderate to almost perfect (0.68-0.98). Spearman's correlation coefficients between corresponding body areas as measured with the ROMS or BFM were all above 0.82. Conclusion: The ROMS is a reliable and valid instrument to evaluate the severity and distribution of sustained abnormal postures.

Journal Article Type Article
Publication Date Mar 1, 2015
Deposit Date Jul 30, 2014
Journal Pain Medicine (United States)
Print ISSN 1526-2375
Electronic ISSN 1526-4637
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 16
Issue 3
Pages 488-493
Keywords rating scale, abnormal postures, active range of motion, reliability, validity
complex regional pain syndrome
Public URL
Publisher URL
Contract Date Mar 2, 2016