Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh Gait Score Reliability)

Abstract

Visual evaluation may be used for outcome studies to explore clinical changes in CP patients over time and may be associated to other validated evaluation tools.

Reliability and validity of Edinburgh visual gait score as an evaluation tool for children with cerebral palsy

“…This finding supports what was reported in previous studies [8,11,15] that showed more variation in the validity and reliability of observations of the proximal segments. Some authors consider that the visual assessment of pelvic rotation is very limited since visual observation is limited to evaluating body movements in only two planes [1].…”

“…Reliability improved between the first 10 videos evaluated and the last ten ( Table 3), showing that practice in using EVGS favorably influences the reliability of the score. In a recent study [8] with two rating times, the authors found better interobserver agreement in the second evaluation, indicating a learning effect. These results suggest that consistent practice of observational gait analysis, based on solid knowledge of gait, enhances the repeatability and accuracy of the visual gait evaluation [8,10].…”

“…This scale is easy to use [2,8] and has been validated for use by experienced and inexperienced observers [12]. In addition, good concurrent validity with other assessments [10], good reliability [13] and adequate capacity to detect postoperative changes after multilevel surgery [11], have been demonstrated.…”

“…This information is helpful in the decision making process that guides the treatment of children with cerebral palsy (CP) [2][3][4]. Three dimensional gait analysis (3DGA) has been considered the gold standard of gait assessment, [2,[4][5][6][7][8] providing quantitative analysis of the gait pattern. However, 3DGA requires a high level of expertise as well as expensive and sophisticated equipment [5], which reduce its availability especially in emerging countries [2].…”

“…These variables were assessed in previous studies [8,12,13] with good reliability and validity, making the scale, as described previously, the best visual scale currently available [13]. However, available studies, focused on this scale, have been developed mainly by the Edinburgh group [10][11][12]14]; and in the studies where different groups applied the scale, only specific aspects were addressed such as observer reliability [2,6], influence of experience on reliability [8] and responsiveness of the EVGS to surgical interventions [15]. Therefore, more information is still needed from different groups, to evaluate the role that the scale can have in the routine clinical assessment of gait even when 3D gait analysis is available.…”