Observational gait assessment tools in paediatrics--a systematic review

Area of Science:

• Pediatric Orthopedics
• Movement Science
• Clinical Biomechanics

Background:

• Instrumented gait analysis (IGA) is a precise but costly method for detecting pediatric gait abnormalities.
• Observational gait assessment presents a more accessible, cost-effective alternative for routine clinical use.
• Systematic review of existing observational tools is needed to evaluate their clinical utility.

Purpose of the Study:

• To systematically review and evaluate the reliability and validity of available pediatric observational gait analysis tools compared to IGA.
• To examine the structure, clinical application, and limitations of these observational tools.
• To identify the most suitable tool for routine clinical practice in pediatric gait assessment.

Main Methods:

• Comprehensive literature search across multiple databases (PubMed, CINAHL, AMED, BNI, EMBASE, PEDro, Cochrane Library) up to December 2012.
• Inclusion of studies using structured observational gait assessment tools for children.
• Analysis of included studies for methodological quality, reliability, and validity using pre-established criteria.

Main Results:

• Five tools for Cerebral Palsy (CP) and one for Down Syndrome were identified; nine studies focused on CP.
• No observational tool achieved the consistency of IGA.
• The Edinburgh Visual Gait Score (EVGS) exhibited superior reliability and concurrent validity compared to other tools.
• Limited evidence exists for the clinical use of most tools due to scarce studies.

Conclusions:

• The Edinburgh Visual Gait Score (EVGS) is recommended for assessing CP gait in clinical practice due to its better reliability and validity.
• Further research is needed to validate other tools and explore low-cost technologies to enhance observer accuracy with EVGS.