Reliability of videotaped observational gait analysis in patients with orthopedic impairments

Abstract

BackgroundIn clinical practice, visual gait observation is often used to determine gait disorders and to evaluate treatment. Several reliability studies on observational gait analysis have been described in the literature and generally showed moderate reliability. However, patients with orthopedic disorders have received little attention. The objective of this study is to determine the reliability levels of visual observation of gait in patients with orthopedic disorders.MethodsThe gait of thirty patients referred to a physical therapist for gait treatment was videotaped. Ten raters, 4 experienced, 4 inexperienced and 2 experts, individually evaluated these videotaped gait patterns of the patients twice, by using a structured gait analysis form. Reliability levels were established by calculating the Intraclass Correlation Coefficient (ICC), using a two-way random design and based on absolute agreement.ResultsThe inter-rater reliability among experienced raters (ICC = 0.42; 95%CI: 0.38–0.46) was comparable to that of the inexperienced raters (ICC = 0.40; 95%CI: 0.36–0.44). The expert raters reached a higher inter-rater reliability level (ICC = 0.54; 95%CI: 0.48–0.60). The average intra-rater reliability of the experienced raters was 0.63 (ICCs ranging from 0.57 to 0.70). The inexperienced raters reached an average intra-rater reliability of 0.57 (ICCs ranging from 0.52 to 0.62). The two expert raters attained ICC values of 0.70 and 0.74 respectively.ConclusionStructured visual gait observation by use of a gait analysis form as described in this study was found to be moderately reliable. Clinical experience appears to increase the reliability of visual gait analysis.

Postural orientation in subjects with anterior cruciate ligament injury: development and first evaluation of a new observational test battery

“…A contributing factor could be that the examiners in our study were familiar with the test method since they used the tests in their clinical work and had undergone a training session prior to the assessments. The importance of experience and standardization has also been pointed out by others [6,11]. Notably, there was a lower agreement between occasions 1 and 2 than between Examiners A and B, especially on patients' injured side ( Table 3).…”

Influence of Acute Anterior Cruciate Ligament Deficiency in Gait Variability

“…48 There is a clinical need to develop objective methods of gait evaluation as clinical observations of gait can be subjective, qualitative and sometimes inconsistent, particularly when the observers are not very experienced. 49 Arif et al 20,45 used accelerometers for studying the effect of fatigue on the walking stability of young and elderly subjects. Some researchers have used accelerometry for analysing gait cycle parameters, such as cadence and step length, with an autocorrelation procedure measuring gait regularity and symmetry.…”

A WEARABLE GAIT ANALYSIS SYSTEM USING INERTIAL SENSORS PART II - Evaluation in a Clinical Setting

“…Very frequently, new questionnaires are developed for specific studies or clinics, e.g. (Brunnekreef et al, 2005), (Kawamura et al, 2007). Although various questionnaires evaluate similar features, they often differ largely in rating scheme and variables of interest.…”