Reliability and validity of the gait classification system in children with cerebral palsy (GCS-CP).

Autor: Melanda AG; Department of Surgery, State University of Londrina, Paraná, Brazil; Master's and Doctoral degree program in Rehabilitation Sciences - State University of Londrina, Paraná, Brazil; Gait Analysis Laboratory, Ana Carolina Moura Xavier Hospital Rehabilitation Center, Curitiba, Brazil. Electronic address: melanda@uel.br., Davids JR; Shriners Hospitals for Children, Northern California, 2425 Stockton Blvd, Sacramento, CA 95817, USA. Electronic address: jdavids@shrinenet.org., Pauleto AC; Gait Analysis Laboratory, Ana Carolina Moura Xavier Hospital Rehabilitation Center, Curitiba, Brazil. Electronic address: acpauleto@gmail.com., Pelegrinelli ARM; Laboratory of Applied Biomechanics, LBA. State University of Londrina, Paraná State, Brazil. Electronic address: alexandrepelegrinelli@hotmail.com., Ferreira AEK; Gait Analysis Laboratory, Ana Carolina Moura Xavier Hospital Rehabilitation Center, Curitiba, Brazil. Electronic address: alana.kuntze@hotmail.com., Knaut LA; Gait Analysis Laboratory, Ana Carolina Moura Xavier Hospital Rehabilitation Center, Curitiba, Brazil. Electronic address: luiz.alberto@leverfix.com.br., Lucareli PRG; Department of Rehabilitation Sciences, Human Motion Analysis Laboratory, University Nove de Julho, São Paulo, Brazil. Electronic address: paulolucareli@uni9.pro.br., Smaili SM; Master's and Doctoral degree program in Rehabilitation Sciences - State University of Londrina, Paraná, Brazil; Department of Physiotherapy, Neurofunctional Physical Therapy Research Group (GPFIN) - State University of Londrina, Paraná State, Brazil. Electronic address: suhaila@uel.br.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2022 Oct; Vol. 98, pp. 355-361. Date of Electronic Publication: 2022 Sep 23.
DOI: 10.1016/j.gaitpost.2022.09.083
Abstrakt: Background: Gait classification systems (GCS) may enable clinicians to differentiate gait patterns into clinically significant categories that assist in clinical decision-making and assessment of outcomes. Davids and Bagley in 2014 [1] described a GCS for children with cerebral palsy (GCS-CP). The purpose of our study was to use the GCS-CP for the first time on a sample of patients with CP and to evaluate the reliability and utility of the classification system.
Methods: The gait of 131 children with CP was retrospectively reviewed and classified according to Davids and Bagley's classification using two-dimensional (2D) video and three-dimensional (3D) lower limb kinematics and kinetics. Gross Motor Function Classification System (GMFCS) levels were determined, and the Gait Profile Scores (GPS) calculated to characterize the sample concerning gait classification. The comparison between the groups was performed using the Kruskal-Wallis test with respect to the non-normal distribution of the data. The intrarater and interrater reliability was determined using the Kappa index (k) statistics with 95% CI.
Results: All GCS-CP groups were represented within the evaluated sample. Of the 131 cases evaluated, 127 (96.95%) were able to be classified with respect to sagittal plane stance phase gait deviations. All patients in the sample were able to be classified with respect to sagittal plane swing phase and transverse plane gait deviations. The interrater reliability was 0.596 and 0.485 for the first and second levels of the classification, respectively, according to the Fleiss's Kappa statistics. Intrarater reliability was 0.776 and 0.714 for the raters one and two, respectively, according to the Cohen's Kappa statistics.
Significance: The GCS-CP exhibited clinical utility, successfully classifying almost all subjects with CP in two planes, based upon kinematic and kinetic data. The classification is valid and has moderate interrater and moderate to substantial intrarater reliability.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE