Validation of a visual gait assessment scale for children with hemiplegic cerebral palsy

Area of Science:

• Pediatric Neurology
• Rehabilitation Medicine
• Movement Science

Background:

• Cerebral palsy (CP) significantly impacts motor function, particularly gait, in children.
• Hemiplegic CP affects one side of the body, leading to characteristic gait deviations.
• Objective and reliable clinical tools are crucial for assessing gait impairments in this population.

Purpose of the Study:

• To evaluate the reliability and validity of a visual gait assessment scale.
• To compare the Physician Rating Scale (PRS) with gold-standard 3D gait analysis.
• To determine the clinical utility of PRS for children with hemiplegic cerebral palsy.

Main Methods:

• The Physician Rating Scale (PRS) was used for visual gait assessment by multiple observers.
• Inter-rater and intra-rater reliability of the PRS were calculated.
• Gait parameters from PRS were compared with data from three-dimensional (3D) gait analysis.

Main Results:

• Excellent correlation was found between PRS observers and 3D gait analysis for knee sagittal plane motion during stance.
• Moderate to almost perfect agreement was observed for foot contact and ankle characteristics in stance.
• High reliability supports the PRS as a viable clinical assessment tool.

Conclusions:

• The Physician Rating Scale demonstrates strong reliability and validity for assessing gait in children with hemiplegic cerebral palsy.
• PRS offers a practical alternative or adjunct to 3D gait analysis for specific gait parameters.
• This visual assessment tool can facilitate frequent and effective gait evaluations in clinical settings.