# Validation and reliability of Kinovea video analysis for temporomandibular and cervical range of motion in children with spastic cerebral palsy

## TL;DR

Kinovea software is a reliable and precise tool for measuring jaw and neck movement in children with spastic cerebral palsy, offering a cost-effective alternative to traditional methods.

## Contribution

The study validates Kinovea's use for temporomandibular and cervical range of motion in children with spastic CP.

## Key findings

- Kinovea showed excellent concurrent validity compared to manual goniometry (r = 0.87–0.99).
- Intra- and inter-rater reliability were high (ICC = 0.91–0.97).
- Bland–Altman analysis confirmed consistent agreement between Kinovea and manual goniometry.

## Abstract

Spastic cerebral palsy (CP) affects mandibular and cervical motor control, making accurate assessment of range of motion (ROM) clinically important. Manual goniometry is widely used but observer-dependent, whereas advanced 3D motion systems are costly. Kinovea software offers a two-dimensional, digital video-based alternative; however, its validity in this population remains unclear.

Fifty-two children with spastic CP (mean age = 10.8 ± 2.4 years; GMFCS I–IV) underwent mandibular and cervical ROM assessment using manual goniometry and Kinovea video analysis. Two raters performed measurements twice, 1 week apart. Concurrent validity (Pearson’s r), intra/inter-rater reliability (ICC), SEM, MDC95, and Bland–Altman agreement analyses were conducted.

Kinovea demonstrated excellent concurrent validity compared with manual goniometry (r = 0.87–0.99, p < 0.001) across all assessed movements. Intra- and inter-rater reliability were high (ICC = 0.91–0.97). SEM values ranged from 0.41° to 1.01°, and MDC95 values ranged from 1.13° to 2.79°, indicating high measurement precision. Bland–Altman analysis revealed minimal mean bias and narrow limits of agreement, confirming consistent agreement between methods.

Kinovea provides precise, reproducible, and clinically feasible measurement of temporomandibular and cervical ROM in children with spastic CP when applied under standardized assessment conditions. The availability of SEM and MDC95 values supports its clinical interpretability for monitoring meaningful changes over time, and its digital nature facilitates integration into routine neurorehabilitation and tele-assessment settings.