Κυριακή 8 Ιανουαρίου 2017

Reliability and Minimum Detectable Change of the Gait Deviation Index (GDI) in post-stroke patients

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): Katren Pedroso Correa, Gisele Francini Devetak, Suzane Ketlyn Martello, Juliana Carla de Almeida, Ana Carolina Pauleto, Elisangela Ferretti Manffra
The Gait Deviation Index (GDI) is a summary measure that provides a global picture of gait kinematic data. Since the ability to walk is critical for post-stroke patients, the aim of this study was to determine the reliability and Minimum Detectable Change (MDC) of the GDI in this patient population. Twenty post-stroke patients (11 males, 9 females; mean age, 55.2±9.9years) participated in this study. Patients presented with either right- (n=14) or left-sided (n=6) hemiparesis. Kinematic gait data were collected in two sessions (test and retest) that were 2 to 7days apart. GDI values in the first and second sessions were, respectively, 59.0±8.1 and 60.2±9.4 for the paretic limb and 53.3±8.3 and 53.4±8.3 for the non-paretic limb. The reliability in each session was determined by the intra-class correlation coefficient (ICC) of three strides and, in the test session, their values were 0.91 and 0.97 for the paretic and non-paretic limbs, respectively. Between-session reliability and MDC were determined using the average GDI of three strides from each session. For the paretic limb, between-session ICC, standard error of measurement (SEM), and MDC were 0.84, 3.4 and 9.4, respectively. Non paretic lower limb exhibited between-session ICC, standard error of measurement (SEM), and MDC of 0.89, 2.7 and 7.5, respectively. These MDC values indicate that very large changes in GDI are required to identify gait improvement. Therefore, the clinical usefulness of GDI with stroke patients is questionable.



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Effect of investigator observation on gait parameters in individuals with and without chronic low back pain

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): Joshua Vickers, Austin Reed, Robert Decker, Bryan P. Conrad, Marissa Olegario-Nebel, Heather K. Vincent
Despite the ubiquity of gait assessment in clinic and research, it is unclear how observation impacts gait, particularly in persons with chronic pain and psychological stress. We compared temporal spatial gait patterns in people with and without chronic low back pain (CLBP) when they were aware and unaware of being observed. This was a repeated-measures, deception study in 55 healthy persons (32.0±12.4 yr, 24.2±2.7kg/m2) and persons with CLBP (51.9±17.9 yr, 27.8±4.4kg/m2). Participants performed one condition in which they were unaware of observation (UNW), and three conditions under investigator observation: (1) aware of observation (AWA), (2) investigators watching cadence, (3) investigators watching step length. Participants walked across an 8.4m gait mat, while temporal spatial parameters of gait were collected. The Medical Outcomes Short Form (SF-12), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), and Oswestry Disability Index (ODI) were completed. Significant condition by group interactions were found for velocity and step length (p<0.05). Main effects of study condition existed for all gait variables except for step width. Main effects of group (healthy, LBP) were significant for all variables except for step width (p<0.05). Regression analyses revealed that after accounting for age, sex, and SF-12 mental component score, BDI scores predict velocity changes during walking from the UNW to AWA conditions. These findings show that people change their gait patterns when being observed. Gait analyses may require additional trials before data can reliably be interpreted and used for clinical decision-making.



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The Edinburgh visual gait score – The minimal clinically important difference

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): L.W. Robinson, N.D. Clement, J. Herman, M.S. Gaston
ObjectiveThe primary aim was to define the minimal clinically important difference (MCID) of the Edinburgh Visual Gait Score (EVGS) using correlations with the Gross Motor Function Classification System (GMFCS) and the Functional Assessment Questionnaire (FAQ). The secondary aim was to confirm the numerical value of the MCID in the Gait Profile Score (GPS).MethodThe EVGS and GPS scores for 151 patients with diplegic cerebral palsy (GMFCS Levels I–III) were retrospectively identified from a database held at the study centre. One-hundred and forty-one patients had FAQ data available.ResultsThe EVGS and GPS correlated with increasing GMFCS level (p<0.001) and FAQ score (p<0.001). A gradient of 3.8 (2.9–4.7) for the EVGS and 2.9 (2.1–3.7) for the GPS corresponded to a one-level change in GMFCS level. A gradient of 1.9 (1.3–2.4) for EVGS and 1.5 (1.1–2.0) for GPS corresponded to a one-point change in FAQ.ConclusionsThe authors propose an MCID value of 2.4 for the EVGS; representing the improvement in gait score after surgery that is likely to reflect a clinical improvement in function. This MCID is closely related to other studies defining post-operative improvements in kinematic data (GPS) and may offer guidance to post-surgical changes that might reasonably be expected to either improve or prevent deteriorating function.



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Reliability and Minimum Detectable Change of the Gait Deviation Index (GDI) in post-stroke patients

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): Katren Pedroso Correa, Gisele Francini Devetak, Suzane Ketlyn Martello, Juliana Carla de Almeida, Ana Carolina Pauleto, Elisangela Ferretti Manffra
The Gait Deviation Index (GDI) is a summary measure that provides a global picture of gait kinematic data. Since the ability to walk is critical for post-stroke patients, the aim of this study was to determine the reliability and Minimum Detectable Change (MDC) of the GDI in this patient population. Twenty post-stroke patients (11 males, 9 females; mean age, 55.2±9.9years) participated in this study. Patients presented with either right- (n=14) or left-sided (n=6) hemiparesis. Kinematic gait data were collected in two sessions (test and retest) that were 2 to 7days apart. GDI values in the first and second sessions were, respectively, 59.0±8.1 and 60.2±9.4 for the paretic limb and 53.3±8.3 and 53.4±8.3 for the non-paretic limb. The reliability in each session was determined by the intra-class correlation coefficient (ICC) of three strides and, in the test session, their values were 0.91 and 0.97 for the paretic and non-paretic limbs, respectively. Between-session reliability and MDC were determined using the average GDI of three strides from each session. For the paretic limb, between-session ICC, standard error of measurement (SEM), and MDC were 0.84, 3.4 and 9.4, respectively. Non paretic lower limb exhibited between-session ICC, standard error of measurement (SEM), and MDC of 0.89, 2.7 and 7.5, respectively. These MDC values indicate that very large changes in GDI are required to identify gait improvement. Therefore, the clinical usefulness of GDI with stroke patients is questionable.



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Effect of investigator observation on gait parameters in individuals with and without chronic low back pain

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): Joshua Vickers, Austin Reed, Robert Decker, Bryan P. Conrad, Marissa Olegario-Nebel, Heather K. Vincent
Despite the ubiquity of gait assessment in clinic and research, it is unclear how observation impacts gait, particularly in persons with chronic pain and psychological stress. We compared temporal spatial gait patterns in people with and without chronic low back pain (CLBP) when they were aware and unaware of being observed. This was a repeated-measures, deception study in 55 healthy persons (32.0±12.4 yr, 24.2±2.7kg/m2) and persons with CLBP (51.9±17.9 yr, 27.8±4.4kg/m2). Participants performed one condition in which they were unaware of observation (UNW), and three conditions under investigator observation: (1) aware of observation (AWA), (2) investigators watching cadence, (3) investigators watching step length. Participants walked across an 8.4m gait mat, while temporal spatial parameters of gait were collected. The Medical Outcomes Short Form (SF-12), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), and Oswestry Disability Index (ODI) were completed. Significant condition by group interactions were found for velocity and step length (p<0.05). Main effects of study condition existed for all gait variables except for step width. Main effects of group (healthy, LBP) were significant for all variables except for step width (p<0.05). Regression analyses revealed that after accounting for age, sex, and SF-12 mental component score, BDI scores predict velocity changes during walking from the UNW to AWA conditions. These findings show that people change their gait patterns when being observed. Gait analyses may require additional trials before data can reliably be interpreted and used for clinical decision-making.



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The Edinburgh visual gait score – The minimal clinically important difference

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): L.W. Robinson, N.D. Clement, J. Herman, M.S. Gaston
ObjectiveThe primary aim was to define the minimal clinically important difference (MCID) of the Edinburgh Visual Gait Score (EVGS) using correlations with the Gross Motor Function Classification System (GMFCS) and the Functional Assessment Questionnaire (FAQ). The secondary aim was to confirm the numerical value of the MCID in the Gait Profile Score (GPS).MethodThe EVGS and GPS scores for 151 patients with diplegic cerebral palsy (GMFCS Levels I–III) were retrospectively identified from a database held at the study centre. One-hundred and forty-one patients had FAQ data available.ResultsThe EVGS and GPS correlated with increasing GMFCS level (p<0.001) and FAQ score (p<0.001). A gradient of 3.8 (2.9–4.7) for the EVGS and 2.9 (2.1–3.7) for the GPS corresponded to a one-level change in GMFCS level. A gradient of 1.9 (1.3–2.4) for EVGS and 1.5 (1.1–2.0) for GPS corresponded to a one-point change in FAQ.ConclusionsThe authors propose an MCID value of 2.4 for the EVGS; representing the improvement in gait score after surgery that is likely to reflect a clinical improvement in function. This MCID is closely related to other studies defining post-operative improvements in kinematic data (GPS) and may offer guidance to post-surgical changes that might reasonably be expected to either improve or prevent deteriorating function.



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Reliability and Minimum Detectable Change of the Gait Deviation Index (GDI) in post-stroke patients

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): Katren Pedroso Correa, Gisele Francini Devetak, Suzane Ketlyn Martello, Juliana Carla de Almeida, Ana Carolina Pauleto, Elisangela Ferretti Manffra
The Gait Deviation Index (GDI) is a summary measure that provides a global picture of gait kinematic data. Since the ability to walk is critical for post-stroke patients, the aim of this study was to determine the reliability and Minimum Detectable Change (MDC) of the GDI in this patient population. Twenty post-stroke patients (11 males, 9 females; mean age, 55.2±9.9years) participated in this study. Patients presented with either right- (n=14) or left-sided (n=6) hemiparesis. Kinematic gait data were collected in two sessions (test and retest) that were 2 to 7days apart. GDI values in the first and second sessions were, respectively, 59.0±8.1 and 60.2±9.4 for the paretic limb and 53.3±8.3 and 53.4±8.3 for the non-paretic limb. The reliability in each session was determined by the intra-class correlation coefficient (ICC) of three strides and, in the test session, their values were 0.91 and 0.97 for the paretic and non-paretic limbs, respectively. Between-session reliability and MDC were determined using the average GDI of three strides from each session. For the paretic limb, between-session ICC, standard error of measurement (SEM), and MDC were 0.84, 3.4 and 9.4, respectively. Non paretic lower limb exhibited between-session ICC, standard error of measurement (SEM), and MDC of 0.89, 2.7 and 7.5, respectively. These MDC values indicate that very large changes in GDI are required to identify gait improvement. Therefore, the clinical usefulness of GDI with stroke patients is questionable.



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Effect of investigator observation on gait parameters in individuals with and without chronic low back pain

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): Joshua Vickers, Austin Reed, Robert Decker, Bryan P. Conrad, Marissa Olegario-Nebel, Heather K. Vincent
Despite the ubiquity of gait assessment in clinic and research, it is unclear how observation impacts gait, particularly in persons with chronic pain and psychological stress. We compared temporal spatial gait patterns in people with and without chronic low back pain (CLBP) when they were aware and unaware of being observed. This was a repeated-measures, deception study in 55 healthy persons (32.0±12.4 yr, 24.2±2.7kg/m2) and persons with CLBP (51.9±17.9 yr, 27.8±4.4kg/m2). Participants performed one condition in which they were unaware of observation (UNW), and three conditions under investigator observation: (1) aware of observation (AWA), (2) investigators watching cadence, (3) investigators watching step length. Participants walked across an 8.4m gait mat, while temporal spatial parameters of gait were collected. The Medical Outcomes Short Form (SF-12), Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), and Oswestry Disability Index (ODI) were completed. Significant condition by group interactions were found for velocity and step length (p<0.05). Main effects of study condition existed for all gait variables except for step width. Main effects of group (healthy, LBP) were significant for all variables except for step width (p<0.05). Regression analyses revealed that after accounting for age, sex, and SF-12 mental component score, BDI scores predict velocity changes during walking from the UNW to AWA conditions. These findings show that people change their gait patterns when being observed. Gait analyses may require additional trials before data can reliably be interpreted and used for clinical decision-making.



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The Edinburgh visual gait score – The minimal clinically important difference

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): L.W. Robinson, N.D. Clement, J. Herman, M.S. Gaston
ObjectiveThe primary aim was to define the minimal clinically important difference (MCID) of the Edinburgh Visual Gait Score (EVGS) using correlations with the Gross Motor Function Classification System (GMFCS) and the Functional Assessment Questionnaire (FAQ). The secondary aim was to confirm the numerical value of the MCID in the Gait Profile Score (GPS).MethodThe EVGS and GPS scores for 151 patients with diplegic cerebral palsy (GMFCS Levels I–III) were retrospectively identified from a database held at the study centre. One-hundred and forty-one patients had FAQ data available.ResultsThe EVGS and GPS correlated with increasing GMFCS level (p<0.001) and FAQ score (p<0.001). A gradient of 3.8 (2.9–4.7) for the EVGS and 2.9 (2.1–3.7) for the GPS corresponded to a one-level change in GMFCS level. A gradient of 1.9 (1.3–2.4) for EVGS and 1.5 (1.1–2.0) for GPS corresponded to a one-point change in FAQ.ConclusionsThe authors propose an MCID value of 2.4 for the EVGS; representing the improvement in gait score after surgery that is likely to reflect a clinical improvement in function. This MCID is closely related to other studies defining post-operative improvements in kinematic data (GPS) and may offer guidance to post-surgical changes that might reasonably be expected to either improve or prevent deteriorating function.



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