102. The gait deviation index as an indicator of gait abnormality among degenerative spinal pathologies

Abstract

BACKGROUND CONTEXT The Gait Deviation Index (GDI) is a composite measure of gait abnormality derived from lower-limb joint range-of-motion which is increasingly being reported for clinical gait analysis among neurologic and orthopedic patients. A GDI score of 100 is representative of healthy individuals and decreasing scores represent a greater abnormality. Preliminary data are needed to help assess the utility of GDI as a measure of compromised gait among spine patients and to provide reference values for commonly treated pathologies. PURPOSE The purposes of this study were: (1) to provide preliminary GDI scores and comparison for common degenerative spinal conditions, (2) to test for differences in symmetry of GDI between right and left legs, and (3) to test for relationships between GDI and walking speed. STUDY DESIGN/SETTING Retrospective, non-randomized. PATIENT SAMPLE This study included 82 cervical spondylotic myelopathy (CSM), 98 adult degenerative scoliosis (ADS), 57 degenerative lumbar spondylolisthesis (DLS), 41 single-level lumbar degeneration (LD), and 41 healthy control subjects. OUTCOME MEASURES GDI scores and walking speed. METHODS GDI scores were obtained from healthy adults and four symptomatic degeneration groups: CSM, ADS, DLS, and LD. Clinical gait analysis was done using a three-dimensional motion tracking system. Evaluations were done one week prior to surgical intervention for degeneration groups. Two-Sample t-tests were used to compare degenerative cohorts to healthy controls and for inter-cohort comparisons. Pearson correlations were used to test for significant relationships between GDI and walking speed. RESULTS Degenerative cohorts all showed significantly lower (worse) GDI scores compared to healthy (all p CONCLUSIONS Composite metrics like GDI provide a tempting means to summarize nuanced and complex gait characteristics into a single, comparable value among cohorts. Results of this study provide preliminary GDI scores for common degenerative spine pathologies. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.