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Updated: Apr 8, 2026
Clinical-oriented Three-dimensional Gait Analysis Method for Evaluating Gait Disorder
Published on: March 4, 2018
Gait Deviation Index Correlates With Daily Step Activity in Children With Cerebral Palsy
Nichola C Wilson1, Nada Signal2, Yanto Naude2
1Department of Surgery, The University of Auckland, Auckland, New Zealand; Paediatric Orthopaedic Department, Starship Children's Hospital, Auckland, New Zealand.
Insights
The Gait Deviation Index (GDI) moderately correlates with daily step count in children with cerebral palsy. This suggests gait improvements may enhance community walking, but other measures are needed for a full assessment.
Area of Science:
- Pediatrics
- Biomechanical Engineering
- Rehabilitation Science
Background:
- Cerebral palsy (CP) significantly impacts gait, affecting mobility and quality of life in affected children.
- The Gait Deviation Index (GDI) quantifies overall gait impairment using kinematic data.
- Understanding the relationship between clinical gait measures and real-world walking is crucial for effective intervention.
Purpose of the Study:
- To investigate the association between the GDI and community walking performance (daily step count) in ambulatory children with CP.
- To examine the correlation between the GDI and clinic-based measures of walking capacity, including the 6-minute walk test (6MWT) and walking speed (WS).
Main Methods:
- A cross-sectional study involving 55 ambulatory children with CP (Gross Motor Function Classification System levels I-III, aged 6-18 years).
- Gait analysis was performed to calculate the GDI.
- Community walking performance was assessed using activity monitors, while clinic-based walking capacity was measured by the 6MWT and WS.
Main Results:
- A moderate association was observed between the GDI and daily step count (Spearman ρ=.58, P<.0001).
- Weaker, yet significant, associations were found between the GDI and the 6MWT (Spearman ρ=.4718, P<.0003) and WS (Spearman ρ=.3949, P<.0028).
Conclusions:
- The GDI shows a moderate relationship with community walking performance, indicating that improvements in gait kinematics may translate to better daily mobility.
- While the GDI is valuable for assessing gait impairment, comprehensive evaluation requires incorporating other measures of walking capacity and performance.
Objectives:
To examine the association between the Gait Deviation Index (GDI), a multivariate measure of overall gait impairment, and measures of both community walking performance and walking capacity within the clinic setting in ambulatory children with cerebral palsy.
Design:
Cross-sectional study.
Setting:
Gait analysis, 6-minute walk test (6MWT), and self-selected walking speed (WS) were conducted in laboratory and clinic settings. Activity monitoring was done in participants' community environment.
Participants:
Children with cerebral palsy (N=55; age range, 6-18y) with Gross Motor Function Classification System levels I to III.
Interventions:
Not applicable.
Main Outcome Measures:
The GDI was derived from gait analysis data as a measure of overall gait impairment; an activity monitor was used to capture community walking performance, and the 6MWT and WS were the clinic-based measures of walking capacity.
Results:
Fifty-five children had a median GDI of 78.86 (range, 53.07-105.34). A moderate association was found between the GDI and daily step count (Spearman ρ=.58; 95% confidence interval [CI], .37-.74; P<.0001). Weaker associations were found between the GDI and 6MWT (Spearman ρ=.4718; 95% CI, .2283-.6597; P<.0003) and between the GDI and WS (Spearman ρ=.3949; 95% CI, .1368-.6028; P<.0028).
Conclusions:
The GDI has a moderate association with daily step count, which suggests that interventions that positively change gait kinematics may also affect community walking performance. Although the GDI's deviation from the normal value provides valuable information, other measures are required to provide a complete picture of a child's walking capacity and performance.
