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      CORRELATION BETWEEN VISUAL GAIT ANALYSIS AND FUNCTIONAL ASPECTS IN CEREBRAL PALSY

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          ABSTRACT

          Objective:

          To verify the correlation between visual gait analysis (VGA) by the Edinburgh visual gait score (EVGS) and functional aspects using the Timed Up and Go Test (TUG) and Gross Motor Function Classification System (GMFCS) in individuals with cerebral palsy (CP).

          Methods:

          Retrospective cross sectional study of 35 patients with CP. The mean age 12.61 years old, 94.3% were spastic; 34.4% hemiplegic, 54.3% diplegic, 11.4% triplegic; 45.7% were level II GMFCS, 42.9% level I, 5.7% level III and 5.7% level IV. VGA was analyzed by the Edinburgh visual gait score (EVGS), functional mobility was assessed by TUG and functionality through GMFCS. The Spearman correlation was used for statistical analysis.

          Results:

          The mean EVGS score was 18.97. The mean TUG was 13.71sec. EVGS showed moderate correlation with TUG (r=0.46, p=0.03) and GMFCS (r=0.45, p=0.00).

          Conclusion:

          Worse VGA scores correlate to worse functionality and mobility performance. Due to the observed correlation, it is possible to assert that VGA is a useful tool on evaluation of CP patients. Level of Evidence III, Retrospective Comparative Study.

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          Most cited references50

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          Development and reliability of a system to classify gross motor function in children with cerebral palsy.

          Marie Wood, P Rosenbaum, R Palisano … (1997)
          To address the need for a standardized system to classify the gross motor function of children with cerebral palsy, the authors developed a five-level classification system analogous to the staging and grading systems used in medicine. Nominal group process and Delphi survey consensus methods were used to examine content validity and revise the classification system until consensus among 48 experts (physical therapists, occupational therapists, and developmental pediatricians with expertise in cerebral palsy) was achieved. Interrater reliability (kappa) was 0.55 for children less than 2 years of age and 0.75 for children 2 to 12 years of age. The classification system has application for clinical practice, research, teaching, and administration.
          Article 0 comments Cited 439 times – based on 0 reviews     Review now
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            Investigation of the timed 'up & go' test in children.

            Richard G Carroll, D S Reddihough, Mary Galea … (2005)
            The timed 'Up & Go' test (TUG) is a test of basic or functional mobility in adults which has rarely been used in children. Functional mobility was defined for this study as an individual's ability to manoeuvre his or her body capably and independently to accomplish everyday tasks. Reliability and validity of TUG scores were examined in 176 children without physical disabilities (94 males, 82 females; mean age 5y 9mo [SD 1y 8mo]; range 3 to 9y) and in 41 young people with physical disabilities due to cerebral palsy or spina bifida (20 males, 21 females; mean age 8y 11mo [SD 4y 3mo], range 3 to 19y). Mean TUG score for children without physical disability was 5.9s (SD 1.3). Reliability of the TUG test was high, with intraclass correlation coefficients (ICC) of 0.89 within session, and 0.83 for test-retest reliability. Mean score of the group aged 3 to 5 years was significantly higher (6.7s SD 1.2) than that of the older group (5.1s, SD 0.8; p=0.001). Scores in the younger group reduced significantly over a 5-month follow-up period (p=0.001), indicating that the TUG was responsive to change. Within-session reliability of the TUG in young people with disabilities was very high (ICC=0.99). There were significant differences in TUG scores between children classified at levels I, II, and III of the Gross Motor Function Classification System (p=0.001). TUG scores showed a moderate negative correlation with scores on the Standing and Walking dimensions of the Gross Motor Function Measure (n=22, rho=-0.52, p=0.012). There was no significant difference in TUG scores between typically developing male and female children. The TUG can be used reliably in children as young as 3 years using the protocol described in this paper. It is a meaningful, quick, and practical objective measure of functional mobility. With further investigation, the TUG is potentially useful as a screening test, an outcome measure in intervention studies for young people with disabilities, a measure of disability, and as a measure of change in functional mobility over time.
            Article 0 comments Cited 35 times – based on 0 reviews     Review now
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              Reliability of observational kinematic gait analysis.

              Jeremy Krebs, Stuart J. Edelstein, Robert Fishman (1985)
              Gait analysis, like all clinical assessments, is subject to measurement error. Specification of the extent of measurement error is imperative before drawing conclusions from any test. The purpose of this study was to determine the within-rater and between-rater reliability of observational gait analysis in a pediatric sample wearing knee-ankle-foot orthoses. Three expert observers, using a 3-point scale, rated videotaped gait kinematics of 15 children who had lower limb disability and who wore braces. The rating sessions were then repeated, with one month between sessions. Total agreement (identical ratings), both between-raters and within-raters, occurred in two-thirds of the observations, and an additional 29% of the observations differed by one point. Between-rater intraclass correlation coefficient type 2, 1 was .73; within-rater Pearson product-moment correlation averaged .60. Observational kinematic gait analysis appears to be a convenient, but only moderately reliable, technique.
              Article 0 comments Cited 25 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Acta Ortop Bras
                Journal ID (iso-abbrev): Acta Ortop Bras
                Journal ID (publisher-id): aob
                Title: Acta Ortopedica Brasileira
                Publisher: Departamento de Ortopedia e Traumatologia (DOT/FMUSP)
                ISSN (Print): 1413-7852
                ISSN (Electronic): 1809-4406
                Publication date (Print and electronic): Sep-Oct 2016
                Publication date (Print): Sep-Oct 2016
                Volume: 24
                Issue: 5
                Pages: 259-261
                Affiliations
                [1 ]. Instituto de Neuro-Ortopedia, Caxias do Sul, RS, Brazil.
                Author notes
                Correspondence: Instituto de Neuro-Ortopedia. Rua General Arcy da Rocha Nóbrega, 401, sala 304. 95040-000. Caxias do Sul, RS, Brazil. mairarech@ 123456hotmail.com

                All the authors declare that there is no potential conflict of interest referring to this article.

                Article
                DOI: 10.1590/1413-785220162405162986
                PMC ID: 5266657
                SO-VID: d5d55493-fb76-497f-bc84-60defcb2bcfb
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                Date received : 25 March 2016
                Date accepted : 07 June 2016
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 28, Pages: 3
                Categories
                Subject: Original Articles

                Keywords: gait,cerebral palsy,evaluation.
                Data availability:
                Keywords: gait, cerebral palsy, evaluation.

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