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Reliability of Superficial Peroneal, Sural, and Medial Plantar Nerve Conduction Studies: Analysis of Statistical Methods

Herrera, Esperanza*; Camargo, Diana M.*; Delgado, Diana C.*; Salvini, Tania F.

Journal of Clinical Neurophysiology: October 2009 - Volume 26 - Issue 5 - p 372-379
doi: 10.1097/WNP.0b013e3181baaaea
Original Article

The reliability of medial plantar, sural, and superficial peroneal nerve conduction studies (NCS) has not been widely studied. These nerves are usually involved in distal sensory neuropathies and their serial study is relevant in the clinical setting.

Purpose: To determine the inter- and intrarater reliability of superficial peroneal, sural, and medial plantar NCS in healthy participants.

Methods: Two raters performed the bilateral NCS twice in 20 healthy participants (23.5 ± 3.5 years). Reliability was analyzed by the Bland-Altman method and intraclass correlation coefficient (ICC). Variability was established by the coefficient of variation.

Results: The Bland-Altman method showed a good level of intra- and interrater agreement for all nerves. The amplitude (rater 1) and latency of the medial plantar nerve and the amplitude of the sural nerve (rater 2) had an intrarater ICC of ≥0.75. Interrater analysis showed concordance levels between moderate and very low. The highest coefficients of variations were found for amplitude and the lowest for nerve conduction velocity.

Conclusions: Although the Bland-Altman method confirmed a good intra- and interrater reliability of the studied nerves, ICC analyses showed mixed results. These statistical approaches are complementary, and each one has advantages and disadvantages that must be considered in their application and interpretation.

From the *Department of Physical Therapy, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia; †Department of Physical Therapy, Musculoskeletal Plasticity Unit, Federal University of São Carlos, São Carlos, SP, Brazil.

Address correspondence and reprint requests to Esperanza Herrera, Escuela de Fisioterapia, Ciudad Universitaria Carrera 27 Calle 9, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia; e-mail:

Copyright © 2009 American Clinical Neurophysiology Society