Reliability and validity of Edinburgh visual gait score as an evaluation tool for children with cerebral palsy |
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| Affiliation: | 1. Pediatric Orthopaedics and Foot Surgery, Clinic for Orthopaedic and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany;2. Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstrasse 18, 83229 Aschau i. Chiemgau, Germany;3. Paediatric Orthopaedic Department, University Children''s Hospital Basle (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland;1. Department of Orthopaedics, Royal Hospital for Sick Children Edinburgh, 9 Sciennes Place, Edinburgh EH9 1LF, United Kingdom;2. University of Edinburgh, College of Medicine and Veterinary Medicine, 49 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SB, United Kingdom;3. The Anderson Gait Laboratory, SMART Centre, Astley Ainslie Hospital, 133 Grange Loan, Edinburgh EH9 2, United Kingdom;1. Old Dominion University, School of Physical Therapy and Athletic Training, 3118 Health Sciences Building, Norfolk, VA 23529, United States;2. Daemen College, Physical Therapy Program, 4380 Main Street, Amherst, NY 14226, United States;1. Department of Kinanthropology, Université du Québec à Montréal, C.P. 8888, succursale Centre-Ville, Montréal, QC, Canada H3C 3P8;2. Centre de Réadaptation Marie Enfant du CHU Sainte-Justine, 5200, rue Bélanger Est, Montréal, QC, Canada H1T 1C9;3. Groupe de recherche en activité physique adaptée (GRAPA), C.P. 8888, succursale Centre-Ville, Montréal, QC, Canada H3C 3P8;4. Department of Biomedical Engineering, École polytechnique de Montréal, C.P. 6079, succursale Centre-Ville, Montréal, QC, Canada H3C 3A7;5. Department of Kinesiology, Université de Montréal, Montreal (Qc), CEPSUM, 2100, boul. Édouard-Montpetit, C.P. 6128, succursale Centre-ville, Montréal, QC, Canada H3C 3J7;1. One Small Step Gait Laboratory, Guy’s and St. Thomas’ NHS Foundation Trust, Lower ground, Southwark Wing, Guy''s Hospital, Great Maze Pond, London, SE1 9RT, United Kingdom;2. Division of Imaging Sciences & Biomedical Engineering, 4th Floor, Lambeth Wing St. Thomas'' Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom;3. Department of Medical Engineering and Physics, King’s College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom |
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| Abstract: | Assessment of gait abnormalities in cerebral palsy (CP) is challenging, and access to instrumented gait analysis is not always feasible. Therefore, many observational gait analysis scales have been devised. This study aimed to evaluate the interobserver reliability, intraobserver reliability, and validity of Edinburgh visual gait score (EVGS). Video of 30 children with spastic CP were reviewed by 7 raters (10 children each in GMFCS levels I, II, and III, age 6–12 years). Three observers had high level of experience in gait analysis (10+ years), two had medium level (2–5 years) and two had no previous experience (orthopedic fellows). Interobserver reliability was evaluated using percentage of complete agreement and kappa values. Criterion validity was evaluated by comparing EVGS scores with 3DGA data taken from the same video visit. Interobserver agreement was 60–90% and Kappa values were 0.18–0.85 for the 17 items in EVGS. Reliability was higher for distal segments (foot/ankle/knee 63–90%; trunk/pelvis/hip 60–76%), with greater experience (high 66–91%, medium 62–90%, no-experience 41–87%), with more EVGS practice (1st 10 videos 52–88%, last 10 videos 64–97%) and when used with higher functioning children (GMFCS I 65–96%, II 58-90%, III 35–65%). Intraobserver agreement was 64–92%. Agreement between EVGS and 3DGA was 52–73%. We believe that having EVGS as part of the standardized gait evaluation is helpful in optimizing the visual scoring. EVGS can be a supportive tool that adds quantitative data instead of only qualitative assessment to a video only gait evaluation. |
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| Keywords: | Cerebral palsy Gait analysis Visual score |
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