Papageorgiou Eirini, Everaert Laure, Vandekerckhove Ines, Hanssen Britta, Van Campenhout Anja, Ortibus Els, Desloovere Kaat
Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium.
Department of Physical Medicine and Rehabilitation, University Hospital Leuven, 3000 Leuven, Belgium.
Children (Basel). 2025 Feb 23;12(3):269. doi: 10.3390/children12030269.
In order to classify the gait of children with spastic cerebral palsy (sCP), the "gait pattern classification system for children with sCP" (GaP-CP) has been developed, based on a systematic review and complemented by an additional class of "mild deviations". The objective of the current study was to examine the content and construct validity of the GaP-CP.
Statistical non-parametric comparisons identified the differences between the kinematics (N = 270) and kinetics (N = 208) of children with sCP and children with typically developing gait (N = 56) (content validity-aim 1), and between neighboring patterns (construct validity-aim 2a). Pattern-specific clinical phenotypes were explored based on the differences between all gait patterns (Kruskal-Wallis comparisons with post hoc Mann-Whitney U tests) in patient- and impairment-specific characteristics (construct validity-aim 2b).
The apparent and true equinus were the most and least prevalent patterns, respectively. The majority of the original classification rules were confirmed by the patient data, indicating good content validity of the GaP-CP. Its construct validity was strengthened by distinguishing between gait deviations of neighboring patterns and differentiating between gait patterns based on patient-specific characteristics, leading to pattern-specific phenotypes. Yet, pattern-specific phenotypes could not be clearly defined based on the impairment-specific comparisons.
The current results support the validity of the GaP-CP. Refined classification rules, using more precise terminology, establish a roadmap for its clinical implementation. The pattern-specific clinical phenotypes enable its use in a clinical context and may aid clinical decision-making.
为了对痉挛型脑瘫（sCP）患儿的步态进行分类，已开发出“痉挛型脑瘫患儿步态模式分类系统”（GaP-CP），该系统基于系统评价，并补充了一类“轻度偏差”。本研究的目的是检验GaP-CP的内容效度和结构效度。
采用统计非参数比较法确定痉挛型脑瘫患儿（N = 270）与步态正常发育儿童（N = 56）在运动学（内容效度目标1）和动力学（N = 208）方面的差异，以及相邻模式之间的差异（结构效度目标2a）。基于所有步态模式在患者和损伤特异性特征方面的差异（Kruskal-Wallis比较及事后Mann-Whitney U检验），探索特定模式的临床表型（结构效度目标2b）。
明显马蹄足和真性马蹄足分别是最常见和最不常见的模式。患者数据证实了大多数原始分类规则，表明GaP-CP具有良好的内容效度。通过区分相邻模式的步态偏差以及根据患者特异性特征区分步态模式，其结构效度得到加强，从而产生特定模式的表型。然而，基于损伤特异性比较无法明确界定特定模式的表型。
目前的结果支持GaP-CP的效度。使用更精确术语的细化分类规则为其临床应用制定了路线图。特定模式的临床表型使其能够在临床环境中使用，并可能有助于临床决策。
