Reliability and validity of an activity monitor (IDEEA) in the determination of temporal–spatial gait parameters in individuals with cerebral palsy

Abstract

This study evaluated within- and between-session reliability and validity of temporal–spatial gait parameters derived from the intelligent device for energy expenditure and activity (IDEEA) activity monitor (Minisun, Fresno, CA) in subjects with cerebral palsy, using three-dimensional gait analysis (3-DGA) as the criterion standard. Twenty-five subjects with cerebral palsy (mean age 14.1 years, range 8–23) and 30 control subjects (mean age 14.2 years, range 7–24) completed two 3-DGA, 1 week apart with simultaneous IDEEA data collection. The IDEEA had lower within-session reliability than the 3-DGA for both groups, indicated by greater measurement errors and wider repeatability values for all temporal–spatial parameters. Between-session reliability of 3-DGA was high for both groups with intra-class correlation coefficients (ICC) >0.80. The IDEEA monitor showed high between-session reliability for control subjects (ICC 0.71–0.89), but lower reliability in subjects with cerebral palsy, particularly for walking velocity and stride length (ICC 0.53 and 0.62, respectively). Validity comparison between IDEEA and 3-DGA measures using Bland Altman 95% limits of agreement showed a measurement bias, with the IDEEA over-estimating step and stride length and underestimating cadence in both subject groups compared to 3-DGA. The 95% limits of agreement were smaller in controls (step ±0.20 m; stride ±0.27 m; walking velocity ±0.28 m/s) than in subjects with cerebral palsy (step ±0.36 m; stride ±0.37 m; velocity ±0.58 m/s). Modifications may be necessary to improve the reliability and validity of the IDEEA in children, particularly for use in neurological conditions.