Update on the reliability of gait analysis interpretation in cerebral palsy: Inter-institution agreement.

Autor: Rethlefsen SA; Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA. Electronic address: srethlefsen@chla.usc.edu., Hanson A; Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA., Ciccodicola E; Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA., Hara R; Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA., Kay RM; Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA; Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, USA., Chambers H; Rady Children's Hospital, 3030 Children's Way, San Diego, CA 92123, USA; University of California San Diego School of Medicine, 9500 Gilman Dr., La Jolla, CA 92093, USA., Wren TAL; Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA; Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, USA.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2024 Mar; Vol. 109, pp. 109-114. Date of Electronic Publication: 2024 Jan 30.
DOI: 10.1016/j.gaitpost.2024.01.031
Abstrakt: Background: Studies have shown good reliability for gait analysis interpretation among surgeons from the same institution. However, reliability among surgeons from different institutions remains to be determined.
Research Question: Is gait analysis interpretation by surgeons from different institutions as reliable as it is for surgeons from the same institution?
Methods: Gait analysis data for 67 patients with cerebral palsy (CP) were reviewed prospectively by two orthopedic surgeons from different institutions in the same state, each with > 10 years' experience interpreting gait analysis data. The surgeons identified gait problems and made treatment recommendations for each patient using a rating form. Percent agreement between raters was calculated for each problem and treatment, and compared to expected agreement based on chance using Cohen's kappa.
Results: For problem identification, the greatest agreement was seen for equinus (85% agreement), calcaneus (88%), in-toeing (89%), and out-toeing (90%). Agreement for the remaining problems ranged between 66-78%. Percent agreement was significantly higher than expected due to chance for all issues (p ≤ 0.01) with modest kappa values ranging from 0.12 to 0.51. Agreement between surgeons for treatment recommendations was highest for triceps surae lengthening (89% agreement), tibial derotation osteotomy (90%), and foot osteotomy (87%). Agreement for the remaining treatments ranged between 72-78%. Percent agreement for all treatments was significantly higher than the expected values (p ≤ 0.002) with modest kappa values ranging from 0.22 to 0.52.
Significance: Previous research established that computerized gait analysis data interpretation is reliable for surgeons within a single institution. The current study demonstrates that gait analysis interpretation can also be reliable among surgeons from different institutions. Future research should examine reliability among physicians from more institutions to confirm these results.
Competing Interests: Declaration of Competing Interest Robert Kay, MD owns stock in Pfizer, Zimmer-Biomet, Medtronic and Johnson & Johnson. The remaining authors have no potential conflicts of interest.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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