title: Reliability and validity of Edinburgh visual gait score as an evaluation tool for children with cerebral palsy.
abstract: Assessment of gait abnormalities in cerebral palsy (CP) is challenging, and access to instrumented gait analysis is not always feasible. Therefore, many observational gait analysis scales have been devised. This study aimed to evaluate the interobserver reliability, intraobserver reliability, and validity of Edinburgh visual gait score (EVGS). Video of 30 children with spastic CP were reviewed by 7 raters (10 children each in GMFCS levels I, II, and III, age 6-12 years). Three observers had high level of experience in gait analysis (10+ years), two had medium level (2-5 years) and two had no previous experience (orthopedic fellows). Interobserver reliability was evaluated using percentage of complete agreement and kappa values. Criterion validity was evaluated by comparing EVGS scores with 3DGA data taken from the same video visit. Interobserver agreement was 60-90% and Kappa values were 0.18-0.85 for the 17 items in EVGS. Reliability was higher for distal segments (foot/ankle/knee 63-90%; trunk/pelvis/hip 60-76%), with greater experience (high 66-91%, medium 62-90%, no-experience 41-87%), with more EVGS practice (1st 10 videos 52-88%, last 10 videos 64-97%) and when used with higher functioning children (GMFCS I 65-96%, II 58-90%, III 35-65%). Intraobserver agreement was 64-92%. Agreement between EVGS and 3DGA was 52-73%. We believe that having EVGS as part of the standardized gait evaluation is helpful in optimizing the visual scoring. EVGS can be a supportive tool that adds quantitative data instead of only qualitative assessment to a video only gait evaluation.
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Del Pilar Duque Orozco
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: Oussama
authors.initials: O
authors.lastname: Abousamra
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Church
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Lennon
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: John
authors.initials: J
authors.lastname: Henley
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Rogers
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: Julieanne P
authors.initials: JP
authors.lastname: Sees
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Connor
authors.affiliation: Department of Orthopedics, Nemours/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington DE 19803, USA. Electronic address: Freeman.Miller@nemours.org.
authors.forename: Freeman
authors.initials: F
authors.lastname: Miller
mesh_terms: D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D012372:ROC Curve; D015203:Reproducibility of Results; D014741:Video Recording
keywords: Cerebral palsy; Gait analysis; Visual score