KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium.
KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Leuven, Belgium.
J Biomech. 2024 Nov;176:112301. doi: 10.1016/j.jbiomech.2024.112301. Epub 2024 Aug 31.
Three-dimensional gait analysis is the 'gold standard' for measurement and description of gait. Gait variability can arise from intrinsic and extrinsic factors and may vary between walking conditions. This study aimed to define the inter-trial and inter-session repeatability in gait analysis data of children with cerebral palsy (CP) who were walking in four conditions, namely barefoot or with ankle-foot orthosis (AFO), and overground or treadmill. Ten children with spastic CP (7♀; 9.9y ± 3.5y; GMFCS-level I-III) were included in this study. Overall, we found good to excellent intra-class correlation (ICC)-values and favourable standard error of measurement (SEM)-values for the inter-session Gait Profile Score (ICC = 0.85-0.98, SEM = 0.45-0.91°) and Gait Variable Scores (ICC = 0.85-0.99, SEM = 0.22-1.11°) for the lower-limb joints. Taking the total joint-range-of-motion into account, the knee joint showed the most repeatable motion (%SEM = 0.5-1.8 %), while ankle motions showed the lowest repeatability (%SEM = 0.8 %-3.0 %). For the continuous waveform data, only the ankle joint showed repeatability differences between walking conditions, namely, smaller SEM-values for the AFO-condition (mean inter-trial = 0.14°; mean inter-session = 1.121°) in comparison to the barefoot-condition (mean inter-trial = 0.55°; mean inter-session = 2.22°). For all the kinetic parameters, the treadmill conditions showed smaller SEM-values in comparison to the overground condition. In conclusion three-dimensional gait analysis was found to be reliable in all four walking conditions for children with CP. The resulting measurement errors can be used as a reference during clinical interpretations of gait analyses. Clinical trial registration number: Trial ID from an internationally recognized trial registry (ClinicalTrials.gov): NCT06355869.
三维步态分析是测量和描述步态的“金标准”。步态的可变性可能源于内在和外在因素，并且在不同的步行条件下可能会有所不同。本研究旨在定义在四种条件下（赤脚或踝足矫形器（AFO），以及地面或跑步机）行走的脑瘫儿童的步态分析数据的试验内和试验间重复性。本研究纳入了 10 名痉挛型脑瘫儿童（7 名女性；9.9 岁±3.5 岁；GMFCS 级别 I-III）。总体而言，我们发现步态分析数据的组内相关系数（ICC）值和测量误差（SEM）值良好到极好，适用于下肢关节的步态分析总评分数（ICC=0.85-0.98，SEM=0.45-0.91°）和步态变量分数（ICC=0.85-0.99，SEM=0.22-1.11°）。考虑到关节总活动范围，膝关节的运动具有最高的可重复性（%SEM=0.5-1.8%），而踝关节的运动具有最低的可重复性（%SEM=0.8%-3.0%）。对于连续波形态数据，只有踝关节在行走条件之间显示出可重复性差异，即在 AFO 条件下（平均试验内=0.14°；平均试验间=1.121°）的 SEM 值较小，而在赤脚条件下（平均试验内=0.55°；平均试验间=2.22°）。对于所有动力学参数，跑步机条件下的 SEM 值均小于地面条件下的 SEM 值。总之，三维步态分析在脑瘫儿童的所有四种行走条件下均具有可靠性。所产生的测量误差可用于步态分析的临床解释过程中的参考。临床试验注册号：来自国际公认的临床试验注册库（ClinicalTrials.gov）的试验 ID：NCT06355869。
