title: Gait Deviation Index Correlates With Daily Step Activity in Children With Cerebral Palsy.
abstract: OBJECTIVE
  To examine the association between the Gait Deviation Index (GDI), a multivariate measure of overall gait impairment, and measures of both community walking performance and walking capacity within the clinic setting in ambulatory children with cerebral palsy.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Gait analysis, 6-minute walk test (6MWT), and self-selected walking speed (WS) were conducted in laboratory and clinic settings. Activity monitoring was done in participants' community environment.
  
  
  METHODS
  Children with cerebral palsy (N=55; age range, 6-18y) with Gross Motor Function Classification System levels I to III.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The GDI was derived from gait analysis data as a measure of overall gait impairment; an activity monitor was used to capture community walking performance, and the 6MWT and WS were the clinic-based measures of walking capacity.
  
  
  RESULTS
  Fifty-five children had a median GDI of 78.86 (range, 53.07-105.34). A moderate association was found between the GDI and daily step count (Spearman ρ=.58; 95% confidence interval [CI], .37-.74; P<.0001). Weaker associations were found between the GDI and 6MWT (Spearman ρ=.4718; 95% CI, .2283-.6597; P<.0003) and between the GDI and WS (Spearman ρ=.3949; 95% CI, .1368-.6028; P<.0028).
  
  
  CONCLUSIONS
  The GDI has a moderate association with daily step count, which suggests that interventions that positively change gait kinematics may also affect community walking performance. Although the GDI's deviation from the normal value provides valuable information, other measures are required to provide a complete picture of a child's walking capacity and performance.
authors.affiliation: Department of Surgery, The University of Auckland, Auckland, New Zealand; Paediatric Orthopaedic Department, Starship Children's Hospital, Auckland, New Zealand. Electronic address: n.wilson@auckland.ac.nz.
authors.forename: Nichola C
authors.initials: NC
authors.lastname: Wilson
authors.affiliation: Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Nada
authors.initials: N
authors.lastname: Signal
authors.affiliation: Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Yanto
authors.initials: Y
authors.lastname: Naude
authors.affiliation: Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Denise
authors.initials: D
authors.lastname: Taylor
authors.affiliation: Department of Surgery, The University of Auckland, Auckland, New Zealand; Paediatric Orthopaedic Department, Starship Children's Hospital, Auckland, New Zealand.
authors.forename: Ngaire S
authors.initials: NS
authors.lastname: Stott
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology*; D002648:Child; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009048:Motor Skills; D016138:Walking / Q000502:physiology*
keywords: Activities of daily living; Cerebral palsy; Gait; Rehabilitation