Assessment of gait in toddlers with normal motor development and in hemiplegic children with mild motor impairment: a validity study

Abstract

| Background: The optimization of gait performance is an important goal in the rehabilitation of children with cerebral palsy (CP) who present a prognosis associated with locomotion. Gait analysis using videos captured by digital cameras requires validation. Objective: To evaluate the validity of a method that involves the analysis of videos captured using a digital camera for quantifying the temporal parameters of gait in toddlers with normal motor development and children with CP. Method: Eleven toddlers with normal motor development and eight children with spastic hemiplegia who were able to walk without assistive devices were asked to walk through a space contained in the visual field of two instruments: a digital camera and a three-dimensional motion analysis system, Qualisys Pro-Reflex. The duration of the stance and swing phases of gait and of the entire gait cycle were calculated by analyzing videos captured by a digital camera and compared to those obtained by Qualisys Pro-Reflex, which is considered a highly accurate system. Results: The Intraclass Correlation Coefficient (ICC) demonstrated excellent agreement (ICC>0.90) between the two procedures for all measurements, except for the swing phase of the normal toddlers (ICC=0.35). The standard error of measurement was less than 0.02 seconds for all measures. Conclusions: The results reveal similarities between the two instruments, suggesting that digital cameras can be valid instruments for quantifying two temporal parameters of gait. This congruence is of clinical and scientific relevance and validates the use of digital cameras as a resource for helping the assessment and documentation of the therapeutic effects of interventions targeted at the gait of children with CP.Keywords: gait; toddlers; cerebral palsy; image processing; computer-assisted; rehabilitation. HOW TO CITE THIS ARTICLEFigueiredo PRP, Silva PLP, Avelar BS, Chagas PSC, Oliveira LCP, Mancini MC. Assessment of gait in toddlers with normal motor development and in hemiplegic children with mild motor impairment: a validity study. Braz J Phys Ther. 2013 July-Aug; 17(4):359-366. http://dx

How do novice and improver walkers move in their home environments? An open-sourced infant’s gait video analysis

“…Novice infant walkers have longer stance phase duration (0.80 s for right leg, and 0.79 s for left leg) in comparison with more mature improver walkers (0.59 s for both legs). In comparison to other literature collected in laboratory environments the mature improver walker values are most consistent with those reported as adopting gait 0.52 s SD 0.11 [17] and within the first week of independent walking 0.45 IQR 0.22 [24]. This stance phase related finding contrasts the natural maturation in walking pattern of single leg stance described in existing literature: the more experienced walker the longer single leg stance phase duration [25,26] until a level equivalent to that of a normal adult is reached, by 3.5–4 years of age [26].…”

“…However, the data presented in these two studies still includes data in an unfamiliar and contrived environment, which is not the home environment of the infant. Other methods mentioned in literature which could be used for collecting real world data include video recording [13,17] wireless inertial sensors [8] and 3D motion capture systems [10]. Despite these systems being effective in real world conditions, all authors used them only in laboratory or clinical environments to investigate infant gait.…”

Technology-Based Feedback and Its Efficacy in Improving Gait Parameters in Patients with Abnormal Gait: A Systematic Review

“…The following gait parameters were assessed in the selected RCTs, in descending order of frequency: speed (cm/s) [ 7 , 15 , 17 , 18 , 19 , 22 , 23 , 38 , 40 , 41 ], step length (m) [ 15 , 17 , 18 , 19 , 22 , 23 , 38 , 41 , 42 ], and cadence (steps/min) [ 5 , 15 , 18 , 23 ]. These parameters were chosen because the unit of gait is the step and time-space parameters are essential for its assessment [ 2 , 52 , 53 , 54 , 55 ]. The measurement devices were in some cases also those providing the feedback [ 7 , 10 , 14 , 19 , 26 , 39 , 40 , 41 , 42 ].…”

Relationship between Spasticity and Motor Abilities in Children with Hemiplegia

“…Such changes are most likely due to muscle weakness and impaired dexterity in the affected side of the body, which may hinder weight transfer to and weight bearing capacity of the affected limb during gait [5] .…”