Correa Katren Pedroso, Devetak Gisele Francini, Martello Suzane Ketlyn, de Almeida Juliana Carla, Pauleto Ana Carolina, Manffra Elisangela Ferretti
Pontifícia Universidade Católica do Paraná, Health Technology Graduate Programm, Rua Imaculada Conceição, 1155, Curitiba, 80215-901, Brazil.
Centro Hospitalar de Reabilitação Ana Carolina Moura Xavier, Rua Quintino Bocaiuva, 329, Curitiba, 80035-090, Brazil.
Gait Posture. 2017 Mar;53:29-34. doi: 10.1016/j.gaitpost.2016.12.012. Epub 2016 Dec 23.
The Gait Deviation Index (GDI) is a summary measure that provides a global picture of gait kinematic data. Since the ability to walk is critical for post-stroke patients, the aim of this study was to determine the reliability and Minimum Detectable Change (MDC) of the GDI in this patient population. Twenty post-stroke patients (11 males, 9 females; mean age, 55.2±9.9years) participated in this study. Patients presented with either right- (n=14) or left-sided (n=6) hemiparesis. Kinematic gait data were collected in two sessions (test and retest) that were 2 to 7days apart. GDI values in the first and second sessions were, respectively, 59.0±8.1 and 60.2±9.4 for the paretic limb and 53.3±8.3 and 53.4±8.3 for the non-paretic limb. The reliability in each session was determined by the intra-class correlation coefficient (ICC) of three strides and, in the test session, their values were 0.91 and 0.97 for the paretic and non-paretic limbs, respectively. Between-session reliability and MDC were determined using the average GDI of three strides from each session. For the paretic limb, between-session ICC, standard error of measurement (SEM), and MDC were 0.84, 3.4 and 9.4, respectively. Non paretic lower limb exhibited between-session ICC, standard error of measurement (SEM), and MDC of 0.89, 2.7 and 7.5, respectively. These MDC values indicate that very large changes in GDI are required to identify gait improvement. Therefore, the clinical usefulness of GDI with stroke patients is questionable.
步态偏差指数（GDI）是一种汇总测量指标，可提供步态运动学数据的整体情况。由于行走能力对中风后患者至关重要，本研究的目的是确定GDI在该患者群体中的可靠性和最小可检测变化（MDC）。20名中风后患者（11名男性，9名女性；平均年龄55.2±9.9岁）参与了本研究。患者表现为右侧（n = 14）或左侧（n = 6）偏瘫。在间隔2至7天的两个时段（测试和复测）收集运动步态数据。患侧肢体在第一和第二时段的GDI值分别为59.0±8.1和60.2±9.4，非患侧肢体分别为53.3±8.3和53.4±8.3。每个时段的可靠性由三步的组内相关系数（ICC）确定，在测试时段，患侧和非患侧肢体的ICC值分别为0.91和0.97。使用每个时段三步的平均GDI确定时段间可靠性和MDC。对于患侧肢体，时段间ICC、测量标准误差（SEM）和MDC分别为0.84、3.4和9.4。非患侧下肢的时段间ICC、测量标准误差（SEM）和MDC分别为0.89、2.7和7.5。这些MDC值表明，需要GDI有非常大的变化才能识别步态改善。因此，GDI对中风患者的临床实用性值得怀疑。
