Association between Gait Deviation Index and Physical Function in Children with Bilateral Spastic Cerebral Palsy: A Cross-Sectional Study

Ito, Tadashi; Noritake, Koji; Sugiura, Hiroshi; Kamiya, Yasunari; Tomita, Hidehito; Ito, Yuji; Sugiura, Hideshi; Ochi, Nobuhiko; Yoshihashi, Yuji

doi:10.3390/jcm9010028

Cited by 24 publications

(16 citation statements)

References 30 publications

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“…Malt et al and Maanum et al report identical mean GDI values for GMFCS levels I and II [26,40]. Additionally, though evaluating patients with bilateral CP, Ito et al described the same mean values for the different GMFCS levels as found during our investigation [41]. It seems, that the GDI might reflect GMFCS levels independently from the underlying neurological disorder.…”

Section: Discussionsupporting

confidence: 76%

Gait Indices for Characterization of Patients with Unilateral Cerebral Palsy

Tsitlakidis

Schwarze

Westhauser

et al. 2020

JCM

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As cerebral palsy (CP) is a complex disorder, classification of gait pathologies is difficult. It is assumed that unclassified patients show less functional impairment and less gait deviation. The aim of this study was to assess the different subgroups and the unclassified patients with unilateral CP using different gait indices. The Gillette Gait Index (GGI), Gait Deviation Index (GDI), Gait Profile Score (GPS) and spatiotemporal parameters derived from instrumented 3D-Gait Analysis (IGA) were assessed. Subgroups were defined using morphological and functional classification systems. Regarding the different gait indices, a ranking of the different gait patterns is evident. Significant differences were found between GMFCS level I and II, Winters et al. (Winters, Gage, Hicks; WGH) type IV and type I and the WGH-unclassified. Concerning the spatiotemporal parameters significant differences were found between GMFCS level I and II concerning velocity. The unclassified patients showed mean values for the different gait indices that were comparable to those of established subgroups. Established gait patterns cause different degrees of gait deviation and functional impairment. The unclassified patients do not differ from established gait patterns but from the unimpaired gait. Further evaluation using 3D-IGA is necessary to identify the underlying gait pathologies of the unclassified patients.

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Section: Discussionsupporting

confidence: 76%

Gait Indices for Characterization of Patients with Unilateral Cerebral Palsy

Tsitlakidis

Schwarze

Westhauser

et al. 2020

JCM

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“…Alternation of GDI, a new multi-variate measure of overall gait performance obtained from walking strides to derive a set of mutually independent joint rotation patterns that e ciently describe gait pathology (ranging from 0 to 100. GDI of 100 means that there is no gait pathology) was also used to assess the gait pattern changes in our cases after SDR [16][17][18][19][20][21] . Results showed general improvements of GDI in those affected sides, resulting into GDI elevation in both sides at the last time of GA assessment after a mean duration of 9.9 months post-SDR rehabilitation therapy.…”

Section: Discussionmentioning

confidence: 99%

Short-term Gait Parameters Change in Mild Spastic Cerebral Palsy after Selective Dorsal Rhizotomy Guided by Our Newly-Modified Protocol

Jiang¹,

Jiang²,

Yu³

et al. 2021

Preprint

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Background Selective Dorsal Rhizotomy (SDR) guided by our modified protocol can decrease spasticity in certain muscles. This study aimed to investigate gait parameters changes in cerebral palsy (CP) with focal spasticity after SDR in short-term follow-up. Methods CP classified as Gross Motor Function Classification System (GMFCS) level Ⅰ and Ⅱ who underwent SDR were included. Changes of spasticity, gait parameters and gait deviation index (GDI) were retrospectively reviewed. Results This study contained 26 individuals with 44 affected and 8 intact lower limbs (4 monoplegia, 4 hemiplegia and 18 diplegia). Mean age was 5.7 ± 1.9 years-old and follow-up duration was 9.9 ± 6.6 months. After SDR, average spasticity of 108 target muscles decreased from 2.9 ± 0.8 to 1.8 ± 0.6 in Modified Ashworth Scale (MAS). Kinematic curves changed after the surgery in sagittal and transverse plane in affected sides, further investigation showed improvements in ankle and knee. No changes were found in temporal-spatial parameters except decrease in cadence in affected sides. GDI improved significantly in affected limbs. Conclusion In short-term follow up, the new-protocol-guiding SDR can lower focal spasticity, GA showed improvements in kinematic parameters and GDI. Longer follow-up duration is needed to clarify the long-term outcome.

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“…(2) In the second stage, we adopted the idea suggested by Schwartz [ 66 ], which find many applications in the literature [ 67 , 68 , 72 , 73 ]. It consists of multiplying a ratio by 10 and subtract them from 100 to give at each stride a gait deviation index we labeled

(Equation (7)):

where

is the suggested risk of falling (ROFA) score according to the gait parameter

.…”

Section: Methodsmentioning

confidence: 99%

Risk of Falling in a Timed Up and Go Test Using an UWB Radar and an Instrumented Insole

Ayena

Chioukh

Otis

et al. 2021

Sensors

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Previously, studies reported that falls analysis is possible in the elderly, when using wearable sensors. However, these devices cannot be worn daily, as they need to be removed and recharged from time-to-time due to their energy consumption, data transfer, attachment to the body, etc. This study proposes to introduce a radar sensor, an unobtrusive technology, for risk of falling analysis and combine its performance with an instrumented insole. We evaluated our methods on datasets acquired during a Timed Up and Go (TUG) test where a stride length (SL) was computed by the insole using three approaches. Only the SL from the third approach was not statistically significant (p = 0.2083 > 0.05) compared to the one provided by the radar, revealing the importance of a sensor location on human body. While reducing the number of force sensors (FSR), the risk scores using an insole containing three FSRs and y-axis of acceleration were not significantly different (p > 0.05) compared to the combination of a single radar and two FSRs. We concluded that contactless TUG testing is feasible, and by supplementing the instrumented insole to the radar, more precise information could be available for the professionals to make accurate decision.

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Association between Gait Deviation Index and Physical Function in Children with Bilateral Spastic Cerebral Palsy: A Cross-Sectional Study

Cited by 24 publications

References 30 publications

Gait Indices for Characterization of Patients with Unilateral Cerebral Palsy

Gait Indices for Characterization of Patients with Unilateral Cerebral Palsy

Short-term Gait Parameters Change in Mild Spastic Cerebral Palsy after Selective Dorsal Rhizotomy Guided by Our Newly-Modified Protocol

Risk of Falling in a Timed Up and Go Test Using an UWB Radar and an Instrumented Insole

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