Department of Pediatric Orthopaedics, Children's Hospital Timone, Mediterranean University, 264 rue Saint-Pierre, Marseille cedex 05, France.
Ann Phys Rehabil Med. 2010 Nov;53(9):535-46. doi: 10.1016/j.rehab.2010.09.002. Epub 2010 Oct 16.
Treatment complexity of cerebral palsy (CP) patients imposes outcome evaluation studies, which may include objective technical analysis and more subjective functional evaluation. The Edinburgh Gait Score (EGS) was proposed as an additive or alternative when complex instrumented three-dimensional gait analysis is not available. Our purposes were to apply a translated EGS to standard video recordings of independent walking spastic diplegic CP patients, to evaluate its intraobserver and interobserver reliability with respect to gait analysis familiar and not familiar observers.
Ten standard video recordings acquired during routine clinical gait analysis were examined by eight observers gait analysis interpretation experienced or not, out of various specialities, two times with a two weeks interval. Kappa statistics and intraclass correlation coefficient were calculated.
Better reliability was observed for foot and knee scores than in proximal segments with significant differences between stance and swing phase. Significantly better results in gait analysis trained observers underlines the importance to either be used to clinical gait analysis interpretation, or to benefit of video analysis training before observational scoring.
Visual evaluation may be used for outcome studies to explore clinical changes in CP patients over time and may be associated to other validated evaluation tools.
脑瘫(CP)患者的治疗复杂性要求进行结果评估研究,其中可能包括客观的技术分析和更主观的功能评估。当无法进行复杂的仪器化三维步态分析时,提出了爱丁堡步态评分(EGS)作为附加或替代方法。我们的目的是将经过翻译的 EGS 应用于痉挛性双瘫 CP 患者独立行走的标准视频记录,评估其在熟悉和不熟悉步态分析观察者的观察者内和观察者间可靠性。
对 10 名在常规临床步态分析中获得的标准视频记录进行了评估,由来自不同专业的 8 名观察者进行了两次评估,两次评估之间间隔两周。计算了 Kappa 统计量和组内相关系数。
与近端节段相比,足部和膝关节评分的可靠性更好,在支撑相和摆动相之间存在显著差异。在经过步态分析培训的观察者中,结果明显更好,这强调了将其用于临床步态分析解释的重要性,或者在进行观察评分之前进行视频分析培训的重要性。
视觉评估可用于结果研究,以探索 CP 患者随时间的临床变化,并且可能与其他经过验证的评估工具相关。