- •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).
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.
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.
Children with cerebral palsy (N=55; age range, 6–18y) with Gross Motor Function Classification System levels I to III.
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.
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).
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.
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
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Archives of Physical Medicine and Rehabilitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Reported outcomes of lower limb orthopaedic surgery in children and adolescents with cerebral palsy: a mapping review.Dev Med Child Neurol. 2014; 56: 808-814
- The Gait Deviation Index: a new comprehensive index of gait pathology.Gait Posture. 2008; 28: 351-357
- Further evidence of validity of the Gait Deviation Index.Gait Posture. 2010; 31: 479-482
- Six-minute walk test in children with cerebral palsy Gross Motor Function Classification System levels I and II: reproducibility, validity, and training effects.Arch Phys Med Rehabil. 2012; 93: 2333-2339
- Test-retest reliability of discrete gait parameters in children with cerebral palsy.Arch Phys Med Rehabil. 2010; 91: 781-787
- Ambulatory physical activity performance in youth with cerebral palsy and youth who are developing typically.Phys Ther. 2007; 87: 248-257
- Development and reliability of a system to classify gross motor function in children with cerebral palsy.Dev Med Child Neurol. 1997; 39: 214-223
- ATS statement: guidelines for the six-minute walk test.Am J Respir Crit Care Med. 2002; 166: 111-117
- One side or two?.Dev Med Child Neurol. 2013; 55: 786-787
- Quality control methods in accelerometer data processing: defining minimum wear time.PLoS One. 2013; 8: e67206
- Flexed-knee gait in children with cerebral palsy: a 10-year follow-up study.J Child Orthop. 2013; 7: 435-443
- How many steps/day are enough? for children and adolescents.Int J Behav Nutr Phys Act. 2011; 8: 78
Published online: June 25, 2015
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.
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.