Repeatability and validation of Gait Deviation Index in children: Typically developing and cerebral palsy

Abstract

The Gait Deviation Index (GDI) is a dimensionless parameter that evaluates the deviation of kinematic gait from a control database. The GDI can be used to stratify gait pathology in children with cerebral palsy (CP). In this paper the repeatability and uncertainty of the GDI were evaluated. The Correlation between the GDI and the Gross Motor Function Classification System (GMFCS) was studied for different groups of children with CP (hemiplegia, diplegia, triplegia and quadriplegia). Forty-nine, typically developing children (TD) formed our database. A retrospective study was conducted on our 3D gait data and clinical exams and 134 spastic children were included. Sixteen TD children completed the gait analysis twice to evaluate the repeatability of the GDI (test-retest evaluation). Monte Carlo simulations were applied for all groups (TD and children with CP) in order to evaluate the propagation of errors stemming from kinematics. The repeatability coefficient (2SD of test-retest differences), obtained on the GDI for the 16 TD children (32 lower limbs) was ± 10. Monte Carlo simulations showed an uncertainty ranging between 0.8 and 1.3 for TD children and all groups with CP. The Spearman Rank correlation showed a moderate correlation between the GDI and the GMFCS (r=-0.44, p<0.0001).

Walking dynamic similarity induced by a combination of Froude and Strouhal dimensionless numbers: Modela-w

“…Therefore, a dimensionless database could be built so as a set of dimensionless mechanical parameters would correspond to a Modela-w. Although the advantages of using database as reference have already been shown [21,25], a dimensionless database removes anthropometric individual characteristics on referenced parameters and would allow to i) compare species [26] and to ii) detect pathology among elderly [23] and young [27] by using deviation indexes [28]. Given that the dimensionless database would gather bio-markers of healthy walking (kinematic and dynamic), a relevant dimensionless deviation index could be proposed to detect a difference due to fitness, pathology, ageing, etc.…”

Gait Deviation Index, Gait Profile Score and Gait Variable Score in children with spastic cerebral palsy: Intra-rater reliability and agreement across two repeated sessions

“…Studies of children with CP have shown that the GDI and GPS demonstrate satisfactory concurrent validity when compared with gold standard measures of gait and gross motor function [3][4][5][6]. They have also shown responsiveness to surgical lengthening of the gastrocnemius muscle [7,8], and the GDI has been reported as a reliable measure within a single session [9]. However, intra-tester reliability and agreement across two separate sessions have, to our knowledge, only been investigated for the GDI in typically developing children, demonstrating limits of agreement of AE10 points and a non-significant difference between the two sessions [9].…”

Autism Spectrum Disorders Gait Identification Using Ground Reaction Forces

“…In this study, the 3D GRF data from single left limb stance from the selected valid trial was analyzed to represent the gait attributes of each participant [22,23]. The time components of the 3D GRF were normalized to the percentage of stance phase time, whereas the 3D GRF amplitudes were normalized to the percentage of the participant's body weight [24,25].…”