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Single-session reliability of discrete gait parameters in ambulatory children with cerebral palsy based on GMFCS
Susan Redekop1, Jan Andrysek, Virginia Wright
1Bloorview Research Institute, Bloorview Kids Rehab, 150 Kilgour Road, Toronto, Ontario, Canada. sredekop@bloorview.ca
Insights
Computerized gait analysis (CGA) reliability in children with cerebral palsy (CP) varies by Gross Motor Function Classification System (GMFCS) level. Higher GMFCS levels require more strides for reliable gait parameter measurement.
Area of Science:
- Biomedical Engineering
- Rehabilitation Medicine
- Pediatric Neurology
Background:
- Cerebral palsy (CP) affects motor function, impacting gait.
- Computerized gait analysis (CGA) is crucial for assessing gait in children with CP.
- Understanding the reliability of CGA parameters is essential for clinical application.
Purpose of the Study:
- To evaluate the single-session reliability of 28 spatiotemporal and kinematic gait variables using CGA.
- To determine the influence of Gross Motor Function Classification System (GMFCS) levels on gait analysis reliability.
- To establish the number of strides needed for reliable gait parameter measurement in children with CP.
Main Methods:
- Gait analysis was performed on 33 ambulatory children with CP (GMFCS Levels I, II, III).
- Intraclass correlation coefficients (ICCs) were used to assess the reliability of 28 discrete gait variables.
- The number of strides required for an ICC of ≥0.90 was calculated for each GMFCS level.
Main Results:
- Reliability of gait parameters was dependent on GMFCS level, with Level I showing the highest reliability (ICC range: 0.70-0.96).
- GMFCS Levels II and III exhibited lower reliability (ICC range: 0.54-0.95 and 0.45-0.98, respectively).
- An average of 4 strides yielded reliable measures for GMFCS Level I, while 6 strides were needed for Levels II and III (excluding pelvis ROM).
Conclusions:
- Single-session reliability of CGA parameters in children with CP is influenced by GMFCS level.
- The number of strides required for reliable gait analysis differs across GMFCS levels.
- Further research on test-retest reliability of these gait parameters in children with CP is recommended.
Abstract:
The single-session reliability of 28 discrete spatiotemporal and kinematic variables was evaluated from computerized gait analysis (CGA) in 33 ambulatory children with cerebral palsy (CP), subcategorized according to Gross Motor Function Classification System (GMFCS) Levels I (n=11), II (n=12) and III (n=10). Nineteen boys and 14 girls participated, mean age=8 years 1 month (S.D.=3 years 0 month). Intraclass correlation coefficients (ICCs) estimated reliability, and the number of strides required to obtain an ICC of at least 0.90 was determined. The reliability of discrete gait parameters was dependent upon GMFCS level, with children in GMFCS Level I exhibiting the highest reliability (ICC range=0.70-0.96). GMFCS Levels II and III had lower levels of reliability with ICC values varying from 0.54 to 0.95 and 0.45 to 0.98, respectively. With the exclusion of pelvis range of motion (ROM), an average of four strides provided a reliability estimate of at least 0.90 for GMFCS Level I, while six strides were needed for children in Levels II and III. On the basis of the intrasession reliability results from the present study, further work is recommended to examine the test-retest reliability of these gait parameters in children with CP.
