Discriminant validity and test re-test reproducibility of a gait assessment in patients with vestibular dysfunction.
BACKGROUND
Gait function may be impaired in patients with vestibular disorders, making gait assessment in the clinical setting relevant for this patient population. The purpose of this study was to evaluate the discriminant validity of a gait assessment protocol between patients with vestibular disorders and healthy participants. Furthermore, test re-test reproducibility and the measurement error of gait performance measures in patients with vestibular lesions was performed under different walking conditions.


METHODS
Gait parameters of thirty-five patients with vestibular disorders and twenty-seven healthy controls were assessed twice with the GAITRite® system. Discriminant validity, reproducibility (intra class correlation [ICC]) and the measurement error (standard error of measurement [SEM], smallest detectable change [SDC]) were determined for gait speed, cadence and step length. Bland-Altman plots were made to assess systematic bias between tests.


RESULTS
A significant effect of grouping on gait performance indicates discriminant validity of gait assessment. All tests revealed differences between patients and healthy controls (p < 0.01). The ICCs for test re-test reproducibility were excellent (0.70-0.96) and measurement error showed acceptable SDC values for gait parameters derived from three walking conditions (9-19 %). Bland-Altman plots indicated no systematic bias.


CONCLUSIONS
Good validity and reproducibility of GAITRite® system measurements suggest that this system could facilitate the study of gait in patients with vestibular disorders in clinical settings. The SDC values for gait are generally small enough to detect changes after a rehabilitation program for patients with vestibular disorders.
Directorate Research and Education Office, Physiotherapy Occupational Therapy Research, University Hospital Zurich, Zurich, Switzerland ; Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
Annatina
A
Schmidheiny
Directorate Research and Education Office, Physiotherapy Occupational Therapy Research, University Hospital Zurich, Zurich, Switzerland ; Department of Physiotherapy, Balgrist University Hospital Zurich, Zurich, Switzerland ; Department of Chiropractic Medicine, Faculty of Medicine, Balgrist University Hospital, Zurich, Switzerland.
Jaap
J
Swanenburg
Department of Neurology, University Hospital, Zurich, Switzerland.
Dominik
D
Straumann
Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland ; Centre for Evidence Based Physiotherapy, Maastricht University, PO Box 616, Maastricht, 6200 MD The Netherlands ; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, PO Box 616, Maastricht, 6200 MD The Netherlands.
Eling D
ED
de Bruin
Directorate Research and Education Office, Physiotherapy Occupational Therapy Research, University Hospital Zurich, Zurich, Switzerland.
Ruud H
RH
Knols
Gait analysis; Reliability; Validity; Vestibular diseases