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Test-retest reliability of discrete gait parameters in children with cerebral palsy
Susan Klejman1, Jan Andrysek, Annie Dupuis
1Bloorview Research Institute, Bloorview Kids Rehab, Toronto, ON, Canada. sue.redekop@utoronto.ca <sue.redekop@utoronto.ca>
Insights
This study found that specific gait measurements in children with cerebral palsy (CP) are reliable for tracking changes over time. These findings support using computerized gait analysis in intervention studies for CP.
Area of Science:
- Biomedical Engineering
- Rehabilitation Science
- Pediatric Physical Therapy
Background:
- Cerebral palsy (CP) affects motor function, impacting gait.
- Objective gait parameters are crucial for assessing interventions in children with CP.
- Understanding the reliability of these parameters is essential for accurate outcome measurement.
Purpose of the Study:
- To assess the test-retest reliability of discrete gait parameters in children with CP across Gross Motor Function Classification System (GMFCS) levels I-III.
- To quantify measurement error using standard error of measurement (SEM) and minimal detectable change (MDC).
- To identify gait parameters most sensitive to change in children with CP.
Main Methods:
- Test-retest reliability study design.
- Involved 28 ambulatory children with CP.
- Gait parameters analyzed using computerized gait analysis in a human movement laboratory.
Main Results:
- High reliability (ICC .84-.97) for sagittal plane and temporal-spatial parameters across GMFCS levels.
- Variable reliability (ICC .46-.91) for frontal and transverse plane parameters.
- Ankle kinematics (Level II) and hip/pelvis parameters (Levels I & III) showed least responsiveness based on MDC.
Conclusions:
- Select discrete gait parameters from computerized analysis are reliable and responsive.
- These parameters can serve as valid outcome measures in intervention studies for children with CP.
- Reliability varies by GMFCS level, with Level III showing higher variability.
Objectives:
To examine the test-retest reliability of discrete gait parameters in children with cerebral palsy (CP) in Gross Motor Function Classification System (GMFCS) levels I, II, and III; to calculate the measurement error between testing sessions of these parameters in the total sample and within GMFCS subgroups using the standard error of measurement; and to evaluate the minimal detectable change (MDC) to identify discrete gait parameters that are most sensitive to change in children with CP.
Design:
Test-retest reliability study.
Setting:
Rehabilitation facility with human movement laboratory.
Participants:
Ambulatory children with CP (N=28).
Interventions:
Not applicable.
Main Outcome Measures:
Intraclass correlation coefficients (ICCs), standard error of measurement, and MDC of discrete gait parameters.
Results:
Parameters measured in the sagittal plane and temporal-spatial parameters were highly reliable across all GMFCS levels (ICC range, .84-.97), while test-retest reliability in the frontal and transverse planes varied from poor to excellent (ICC range, .46-.91). Using MDC as a guide, hip and pelvis parameters in the transverse and frontal planes were least responsive for GMFCS levels I and III (MDC ranges, 8.3 degrees -18.0 degrees and 2.7 degrees -23.4 degrees , respectively), whereas ankle kinematics were the least responsive for level II (MDC range, 8.2 degrees -11.9 degrees ). Reliability was dependent on mobility level, with children in GMFCS level III exhibiting greater test-retest variability overall.
Conclusions:
Our findings suggest that select discrete gait parameters measured using computerized gait analysis are reliable and potentially responsive measures of performance and can be used as outcome measures in intervention studies.
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