Related Experiment Video
Updated: Aug 18, 2026
Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
Published on: November 7, 2014
Gait in children with cerebral palsy: observer reliability of Physician Rating Scale and Edinburgh Visual Gait
Karel G B Maathuis1, Cees P van der Schans, Andries van Iperen
1Department of Rehabilitation, University Hospital Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands. c.g.b.maathuis@rev.umcg.nl
Insights
The Physician Rating Scale (PRS) and Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale show excellent intraobserver reliability but poor interobserver reliability for children with cerebral palsy (CP). Longitudinal CP gait assessments should use a single observer.
Area of Science:
- Pediatric Neurology
- Movement Disorders
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) significantly impacts gait in children.
- Quantitative observational scales like the Physician Rating Scale (PRS) and Edinburgh Visual Gait Analysis Interval Testing (GAIT) are used to evaluate gait.
- Assessing the reliability of these scales is crucial for consistent clinical application in pediatric CP populations.
Purpose of the Study:
- To evaluate the inter- and intraobserver reliability of the PRS and GAIT scales.
- To determine the suitability of these scales for assessing gait in children diagnosed with cerebral palsy.
Main Methods:
- Twenty-four children (ages 3-10) with CP-related abnormal gait participated.
- Video recordings of gait were independently scored twice by three observers with a minimum 6-week interval.
- The Physician Rating Scale (PRS) and Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale were utilized for scoring.
Main Results:
- Both the GAIT scale and PRS demonstrated excellent intraobserver reliability.
- However, both scales exhibited poor interobserver reliability among the three independent raters.
- Systematic differences in total scores were observed between observers for both the GAIT and PRS scales.
Conclusions:
- While individual observers are consistent (excellent intraobserver reliability), different observers yield dissimilar results (poor interobserver reliability) when using the PRS and GAIT scales for children with CP.
- The study recommends that longitudinal gait assessments for individual pediatric CP patients should be conducted by a single, consistent observer to minimize variability.
- Further research may be needed to refine these observational tools or develop standardized training protocols to improve interobserver agreement in CP gait analysis.
Abstract:
The aim of this study was to test the inter- and intraobserver reliability of the Physician Rating Scale (PRS) and the Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale for use in children with cerebral palsy (CP). Both assessment scales are quantitative observational scales, evaluating gait. The study involved 24 patients ages 3 to 10 years (mean age 6.7 years) with an abnormal gait caused by CP. They were all able to walk independently with or without walking aids. Of the children 15 had spastic diplegia and 9 had spastic hemiplegia. With a minimum time interval of 6 weeks, video recordings of the gait of these 24 patients were scored twice by three independent observers using the PRS and the GAIT scale. The study showed that both the GAIT scale and the PRS had excellent intraobserver reliability but poor interobserver reliability for children with CP. In the total scores of the GAIT scale and the PRS, the three observers showed systematic differences. Consequently, the authors recommend that longitudinal assessments of a patient should be done by one observer only.
