Institute of Physiotherapy, University of Rzeszów, Warszawska 26 a, 35-205, Rzeszów, Poland.
Rzeszów University of Technology, Rzeszów, Poland.
BMC Pediatr. 2018 Sep 15;18(1):301. doi: 10.1186/s12887-018-1273-x.
In clinical practice there is a need for a specific scale enabling detailed and multifactorial assessment of gait in children with spastic hemiplegic cerebral palsy. The practical value of the present study is linked with the attempts to find a new, affordable, easy-to-use tool for gait assessment in children with spastic hemiplegic cerebral palsy. The objective of the study is to evaluate the Wisconsin Gait Scale (WGS) in terms of its inter- and intra-rater reliability in observational assessment of walking in children with hemiplegic cerebral palsy.
The study was conducted in a group of 34 patients with hemiplegic cerebral palsy. At the first stage, the original version of the ordinal WGS was used. The WGS, consisting of four subscales, evaluates fourteen gait parameters which can be observed during consecutive gait phases. At the second stage, a modification was introduced in the kinematics description of the knee and weight shift, in relation to the original scale. The same video recordings were rescored using the new, paediatric version of the WGS. Three independent examiners performed the assessment twice. Inter and intra-observer reliability of the modified WGS were determined.
The findings show very high inter- and intra-observer reliability of the modified WGS. This was reflected by a lack of systematically oriented differences between the repeated measurements, very high value of Spearman's rank correlation coefficient 0.9 ≤ |R| < 1, very high value of ICC > 0.9, and low value of CV < 2.5% for the specific physical therapists.
The new, ordinal, paediatric version of WGS, proposed by the authors, seems to be useful as an additional tool that can be used in qualitative observational gait assessment of children with spastic hemiplegic cerebral palsy. Practical dimension of the study lies in the fact that it proposes a simple, easy-to-use tool for a global gait assessment in children with spastic hemiplegic cerebral palsy. However, further research is needed to validate the modified WGS by comparing it to other observational scales and objective 3-dimensional spatiotemporal and kinematic gait parameters.
anzctr.org.au , ID: ACTRN12617000436370 . Registered 24 March 2017.
在临床实践中，需要一种特定的量表来对痉挛性偏瘫脑瘫儿童的步态进行详细的多因素评估。本研究的实际意义在于尝试寻找一种新的、经济实惠、易于使用的工具，用于评估痉挛性偏瘫脑瘫儿童的步态。本研究的目的是评估威斯康星步态量表（WGS）在观察评估偏瘫脑瘫儿童行走时的组内和组间信度。
该研究在 34 名偏瘫脑瘫患儿中进行。在第一阶段，使用了原始的等级 WGS 版本。WGS 由四个分量表组成，评估了在连续步态阶段中可以观察到的 14 个步态参数。在第二阶段，对膝关节和体重转移的运动学描述进行了修改，与原始量表相比。使用新的儿科版 WGS 对相同的视频记录进行重新评分。三名独立的评估员进行了两次评估。确定了修改后的 WGS 的组内和组间信度。
研究结果表明，修改后的 WGS 的组内和组间信度非常高。这反映在重复测量之间没有系统定向的差异，Spearman 秩相关系数 0.9≤|R|＜1 的非常高值，ICC＞0.9 的非常高值，以及特定物理治疗师的 CV＜2.5%的低值。
作者提出的新的等级、儿科版 WGS 似乎可用作一种额外的工具，可用于痉挛性偏瘫脑瘫儿童的定性观察步态评估。本研究的实际意义在于，它提出了一种简单易用的工具，用于评估痉挛性偏瘫脑瘫儿童的整体步态。然而，需要进一步的研究来通过将其与其他观察量表和客观的三维时空和运动学步态参数进行比较来验证修改后的 WGS。
anzctr.org.au，ID：ACTRN12617000436370。于 2017 年 3 月 24 日注册。
