Correlation between the Gait Deviation Index and gross motor function (GMFCS level) in children with cerebral palsy.

Merete A Malt,Jonas M Fevang,Ånen Aarli,Bård Bogen

doi:10.1007/s11832-016-0738-4

Abstract

AimThe Gait Deviation Index (GDI) is a score derived from three-dimensional gait analysis (3DGA). The GDI provides a numerical value that expresses overall gait pathology (ranging from 0 to 100, where 100 indicates the absence of gait pathology). The aim of this study was to investigate the association between the GDI and different levels of gross motor function [defined as the Gross Motor Function Classification System (GMFCS)] and to explore if age, height, weight, gender and cerebral palsy (CP) subclass (bilateral and unilateral CP) exert any influence on the GDI in children with unilateral and bilateral spastic CP.MethodsWe calculated the GDI of 109 children [73 % boys, mean age 9.7 years (standard deviation, SD 3.5)] with spastic CP, classified at GMFCS levels I, II and III. Twenty-three normally developing children were used as controls [61 % boys, mean age 9.9 years (SD 2.6)]. Multiple linear regression analysis was performed.ResultsThe mean GDI in the control group was 100 (SD 7.5). The mean GDI in the GMFCS level I group was 81 (SD 11), in the GMFCS level II group 71 (SD 11) and in the GMFCS level III group 60 (SD 9). Multiple linear regression analysis showed that gender, age and CP subclass had no significant correlation with the GDI, whereas height and weight had a slight impact.ConclusionThis study showed a strong correlation between the GDI and GMFCS levels. The present data indicate that calculation of the GDI is a useful tool to characterise walking difficulties in children with spastic CP.

Highlights

Three-dimensional gait analysis (3DGA) is widely used to describe gait problems, as well as to plan and evaluate the treatment of children with cerebral palsy (CP). 3DGA provides a large amount of data in the form of graphs expressing joint motions, as well as moment and power of the pelvis, hip, knee and ankle joints in three planes [1]
The aim of this study was to investigate the association between the Gait Deviation Index (GDI) and different levels of gross motor function [defined as the Gross Motor Function Classification System (GMFCS)] and to explore if age, height, weight, gender and cerebral palsy (CP) subclass exert any influence on the GDI in children with unilateral and bilateral spastic CP
Multiple linear regression analysis showed that gender, age and CP subclass had no significant correlation with the GDI, whereas height and weight had a slight impact

Summary

Introduction

Three-dimensional gait analysis (3DGA) is widely used to describe gait problems, as well as to plan and evaluate the treatment of children with cerebral palsy (CP). 3DGA provides a large amount of data in the form of graphs expressing joint motions (kinematics), as well as moment and power (kinetics) of the pelvis, hip, knee and ankle joints in three planes (sagittal, frontal and transverse) [1]. Three-dimensional gait analysis (3DGA) is widely used to describe gait problems, as well as to plan and evaluate the treatment of children with cerebral palsy (CP). It is useful to summarise the results from 3DGA into a single, numerical measure that reflects the patient’s gait. Several models have been designed to obtain a single measure of the quality of a gait pattern. The Gillette Gait Index (GGI) has been widely used. These include the component parameters used and difficulties in implementation to the control data. These limitations have been well documented in previous papers [2, 3]

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