An observational treatment-based gait pattern classification method for targeting interventions for older adult males with mobility problems: Validity based on movement control and biomechanical factors

Abstract

BackgroundA reliable and valid observational gait assessment intended to guide clinical intervention for gait deficits in older adults has not been proposed. A quick gait classification method which tailors clinical management for different patterns of gait dysfunction may be useful for clinicians with limited access to apply computer-assisted gait analyses. Research QuestionThis work aims to establish reliability and validity of the Treatment-Based Gait Pattern Classification (TBGPC) that can be used to quickly identify and classify mobility problems of older males, and possibly target interventions for specific gait deficits in clinical settings. MethodVideotapes of 116 older male veterans referred for mobility problems were analyzed in this cross-sectional study. The TBGPC defined by movement control (consistent, inconsistent) and postural biomechanical factors (usual, flexed, extended, crouched) was validated by comparing means of individual items of the Modified Gait Abnormality Rating Scale (GARS-M) across groups. ResultsKappas for interrater reliability of the TBGPC movement control and biomechanical components were 0.59 and 0.75, respectively; for intrarater reliability, 0.82 and 0.72, respectively. Both movement control and biomechanical components were validated. All GARS-M items were different between older males with consistent and inconsistent gait. Within the consistent and inconsistent group, hip ROM was one of the most differentiating GARS-M item between older males with usual and flexed gait and flexed and crouched group. Total GARS-M score and guardedness were two differentiating factors between the usual and crouched group. SignificanceGait patterns of older males were reliably recognized and validated by mean differences in abnormal characteristics of gait across patterns. The TBGPC may be useful to quickly identify and classify mobility problems of older males and to guide clinical intervention.