Reliability of videotaped observational gait analysis in patients with orthopedic impairments.
BACKGROUND
In 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.


METHODS
The 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.


RESULTS
The 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.


CONCLUSIONS
Structured 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.
Brunnekreef
Jaap J
JJ
Department of Physical Therapy, Radboud University Nijmegen, P,O, Box 9101, 6500 HB Nijmegen, the Netherlands. j.brunnekreef@fysiocss.umcn.nl <j.brunnekreef@fysiocss.umcn.nl>
van Uden
Caro J T
CJ
van Moorsel
Steven
S
Kooloos
Jan G M
JG
D000293:Adolescent; D000328:Adult; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D015588:Observer Variation; D026741:Physical Therapy Modalities; D015203:Reproducibility of Results; D014743:Videotape Recording