Abstract
BackgroundIn clinical practice, visual gait observation is often used to determine gait disorders and to evaluate treatment. Several reliability studies on observational gait analysis have been described in the literature and generally showed moderate reliability. However, patients with orthopedic disorders have received little attention. The objective of this study is to determine the reliability levels of visual observation of gait in patients with orthopedic disorders.MethodsThe gait of thirty patients referred to a physical therapist for gait treatment was videotaped. Ten raters, 4 experienced, 4 inexperienced and 2 experts, individually evaluated these videotaped gait patterns of the patients twice, by using a structured gait analysis form. Reliability levels were established by calculating the Intraclass Correlation Coefficient (ICC), using a two-way random design and based on absolute agreement.ResultsThe inter-rater reliability among experienced raters (ICC = 0.42; 95%CI: 0.38–0.46) was comparable to that of the inexperienced raters (ICC = 0.40; 95%CI: 0.36–0.44). The expert raters reached a higher inter-rater reliability level (ICC = 0.54; 95%CI: 0.48–0.60). The average intra-rater reliability of the experienced raters was 0.63 (ICCs ranging from 0.57 to 0.70). The inexperienced raters reached an average intra-rater reliability of 0.57 (ICCs ranging from 0.52 to 0.62). The two expert raters attained ICC values of 0.70 and 0.74 respectively.ConclusionStructured visual gait observation by use of a gait analysis form as described in this study was found to be moderately reliable. Clinical experience appears to increase the reliability of visual gait analysis.
Highlights
In clinical practice, visual gait observation is often used to determine gait disorders and to evaluate treatment
In order to gain insight into how the results may give guidance to physical therapy treatment, this study investigates which items on the gait analysis form, that have been considered to be disturbed by visual observation, receive high priority in the physical therapy treatment program according to the physical therapist who performs the visual gait analysis
Inter-rater reliability The inter-rater reliability among experienced raters was 0.42 (95%CI: 0.38–0.46). This level of reliability is comparable to the inter-rater reliability of in-experienced raters, which reached an Intraclass Correlation Coefficient (ICC) value of 0.40 (95%CI: 0.36– 0.44)
Summary
Visual gait observation is often used to determine gait disorders and to evaluate treatment. The objective of this study is to determine the reliability levels of visual observation of gait in patients with orthopedic disorders. In order to determine treatment goals or to evaluate the effect of a therapeutic intervention, physical therapists visually observe the patient's gait [1,2,3]. Several reliability studies on observational gait analysis have been described in the literature These studies included patients with hemiplegia [5,6,7], amputation [8], neurological diseases [9], cerebral palsy [10], rheumatoid arthritis [11] and spinal cord injuries [12]. Despite the numerous studies on observational gait analysis, patients with orthopedic impairments have received little attention
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