Reliability of Visual Classifi cation of Sagittal Gait Patterns in Patients with Bilateral Spastic Cerebral Palsy
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To investigate the reliability of inspection-based classifi cation of sagittal gait patterns in children with bilateral spastic cerebral palsy (CP). Method Video clip recordings of gait patterns and sagittal kinematic data obtained by a computerized motion analysis system from 91 patients with bilateral spastic CP were reviewed. The abnormal gait patterns were classifi ed into 4 groups using the method described by Rodda et al. Visual observation-based classifi cation (visual classifi cation) was compared with classifi cation by 3D analysis-based methods (3D classifi cation). The reliabilities of visual classifi cations made by an experienced physician and a trainee physician were analyzed. Results The consistency of inspection-based gait classifi cation using kinematic data analysis was demonstrated by an experienced physician (Kappa coeffi cient (k)=0.67, p<0.001). However, the consistency was low for the trainee physician (k=0.37, p<0.001). Group III (apparent equinus) was commonly confused with group IV (crouch gait) by the trainee physician, resulting in lower agreement for those two evaluation groups than for other patterns. Video observation showed low reliability in comparisons made between the experienced and the trainee physician (k=0.37, p<0.001). Conclusion There was substantial agreement of gait classifi cation between video observation and kinematic data analysis by the experienced physician, but not by the trainee physician. Low reliability was also demonstrated for inspection-based gait classifi cation.
Abstract
Objective To investigate the reliability of inspection-based classifi cation of sagittal gait patterns in children with bilateral spastic cerebral palsy (CP). Method Video clip recordings of gait patterns and sagittal kinematic data obtained by a computerized motion analysis system from 91 patients with bilateral spastic CP were reviewed. The abnormal gait patterns were classifi ed into 4 groups using the method described by Rodda et al. Visual observation-based classifi cation (visual classifi cation) was compared with classifi cation by 3D analysis-based methods (3D classifi cation). The reliabilities of visual classifi cations made by an experienced physician and a trainee physician were analyzed. Results The consistency of inspection-based gait classifi cation using kinematic data analysis was demonstrated by an experienced physician (Kappa coeffi cient (k)=0.67, p<0.001). However, the consistency was low for the trainee physician (k=0.37, p<0.001). Group III (apparent equinus) was commonly confused with group IV (crouch gait) by the trainee physician, resulting in lower agreement for those two evaluation groups than for other patterns. Video observation showed low reliability in comparisons made between the experienced and the trainee physician (k=0.37, p<0.001). Conclusion There was substantial agreement of gait classifi cation between video observation and kinematic data analysis by the experienced physician, but not by the trainee physician. Low reliability was also demonstrated for inspection-based gait classifi cation.
참고문헌 (14)
- Rodda J, "Classifi cation of gait patterns in spastic hemiplegia and spastic diplegia: a basis for a management algorithm", Eur J Neurol, 8(Suppl 5), pp.98~108 (2001)
- TF Winters Jr, "Gait patterns in spastic hemiplegia in children and young adults", J Bone Joint Surg Am, 69, pp.437~441 (1987)
- O'Byrne JM, "Quantitative analysis and classifi cation of gait patterns in cerebral palsy using a three-dimensional motion analyzer", J Child Neurol, 13, pp.101~108 (1998)
- Kienast GBD, "Determination of gait patterns in children with cerebral palsy using cluster analysis", Gait Posture, 10, pp.57~ (1999)
- Rodda JM, "Sagittal gait patterns in spastic diplegia", J Bone Joint Surg Br, 86, pp.251~258 (2004)
- DeLuca PA, "Gait analysis in the treatment of the ambulatory child with cerebral palsy", Clin Orthop Relat Res, 264, pp.65~75 (1991)
- Gage JR, "Gait analysis: principle and applications with emphasis on its use in cerebral palsy", Instr Course Lect, 45, pp.491~507 (1996)
- 박은숙, "경직성 뇌성 마비 환아에서 흔하게 나타나는 하지 관절의 보행 이상", Annals of Rehabilitation Medicine, 33(1), pp.64~71 (2009), 대한재활의학회
- Toro B, "Cluster analysis for the extraction of sagittal gait patterns in children with cerebral palsy", Gait Posture, 25, pp.157~165 (2007)
- Mulroy S, "Use of cluster analysis for gait pattern classification of patients in the early and late recovery phases following stroke", Gait Posture, 18, pp.114~125 (2003)
- Wren TA, "Prevalence of specifi c gait abnormalities in children with cerebral palsy: infl uence of cerebral palsy subtype, age, and previous surgery", J Pediatr Orthop, 25, pp.79~83 (2005)
- Bartko JJ, "Measures of agreement: a single procedure", Stat Med, 13, pp.737~745 (1994)
- Rang M, "Cerebral palsy In Pediatric orthopaedics", pp.345~396 (1986), JB Lippincott Company
- Johnson DC, "The evolution of gait in childhood and adolescent cerebral palsy", J Pediatr Orthop, 17, pp.392~396 (1997)