Highlights
- •A moderate association was found between the Gait Deviation Index (GDI) and average daily step count and percentage of time spent in high activity (defined as >42steps/min for 1 individual leg).
- •Weaker associations were found between the GDI and 6-minute walk test and walking speed.
- •No association was found between the GDI and the percentage of time spent in low activity (<15steps/min for individual leg).
Abstract
Objectives
To examine the association between the Gait Deviation Index (GDI), a multivariate
measure of overall gait impairment, and measures of both community walking performance
and walking capacity within the clinic setting in ambulatory children with cerebral
palsy.
Design
Cross-sectional study.
Setting
Gait analysis, 6-minute walk test (6MWT), and self-selected walking speed (WS) were
conducted in laboratory and clinic settings. Activity monitoring was done in participants'
community environment.
Participants
Children with cerebral palsy (N=55; age range, 6–18y) with Gross Motor Function Classification
System levels I to III.
Interventions
Not applicable.
Main Outcome Measures
The GDI was derived from gait analysis data as a measure of overall gait impairment;
an activity monitor was used to capture community walking performance, and the 6MWT
and WS were the clinic-based measures of walking capacity.
Results
Fifty-five children had a median GDI of 78.86 (range, 53.07–105.34). A moderate association
was found between the GDI and daily step count (Spearman ρ=.58; 95% confidence interval
[CI], .37–.74; P<.0001). Weaker associations were found between the GDI and 6MWT (Spearman ρ=.4718;
95% CI, .2283–.6597; P<.0003) and between the GDI and WS (Spearman ρ=.3949; 95% CI, .1368–.6028; P<.0028).
Conclusions
The GDI has a moderate association with daily step count, which suggests that interventions
that positively change gait kinematics may also affect community walking performance.
Although the GDI's deviation from the normal value provides valuable information,
other measures are required to provide a complete picture of a child's walking capacity
and performance.
Keywords
List of abbreviations:
3-DGA (3-dimensional gait analysis), 6MWT (6-minute walk test), CI (confidence interval), CP (cerebral palsy), GDI (Gait Deviation Index), GMFCS (Gross Motor Function Classification System), WS (walking speed)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 25, 2015
Footnotes
Wilson received funding from the Health Research Council of New Zealand and the New Zealand Orthopaedic Association Trust. She reports financial support from Allergan in the form of an education grant to attend an ultrasound course in 2012. The other authors have nothing to disclose.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
