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Updated: Jan 10, 2026
Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
Published on: November 7, 2014
Same patients, different professionals: A comparative study of Edinburgh Visual Gait Scorring accuracy and agreement
Sema Ertan Birsel1, Meltem Celik1, Osman Dogan1
1Ortopediatri Istanbul, Academy of Pediatric Orthopaedics, Istanbul, Turkey.
Background:
Accurate gait assessment in cerebral palsy (CP) is essential for determining treatment strategies. The Edinburgh Visual Gait Score (EVGS) provides a standardized framework for assessing gait deviations visually. However, inter-observer variability between surgeons and physiotherapists may impact the agreement in assessment and decision-making in CP.
Research Question:
Do pediatric orthopedic surgeons and physiotherapists differ in their scoring accuracy and inter-rater reliability when using the Edinburgh Visual Gait Score to assess gait in children with cerebral palsy?
Methods:
This study was conducted among physiotherapists and pediatric orthopedic surgeons who had the same gait assessment training. The gait data of 10 children and the standardized EVGS scoring form were shared with professionals via email. The collected data were analyzed to evaluate both inter-professional agreement between the groups and intragroup consistency within each group and the accuracy level for each group.
Results:
21 physiotherapists and 15 pediatric orthopedic surgeons participated in this study. The overall accuracy of the total EVGS was 55.5 % for pediatric orthopedic surgeons, and 48.3 % for physiotherapists. Pediatric orthopedic surgeons exhibited high-moderate agreement (Krippendorff's Alpha coefficients over 0.70) for parameters of distal segments (foot and knee). However, intragroup reliability for pelvic and hip parameters showed lower agreement with Krippendorff's Alpha coefficients below 0.70. Physiotherapists demonstrated "low agreement" for all items and the total score, with Krippendorff's Alpha values below 0.67.
Significance:
Current study findings reinforce the importance of continued education and practice in maximizing the clinical and research potential of the EVGS. While variability persists between professional groups, the EVGS remains a valid and valuable tool for evaluating gait in CP.
