WASHINGTON — Gait analysis is a promising outcomes assessment tool for children undergoing orthopedic surgery, Norman Y. Otsuka, M.D., said at the annual meeting of the American Academy of Orthopaedic Surgeons.
Results of a study comparing three-dimensional computerized gait analysis with various measures of function and quality of life suggest that gait analysis “reflects real functional abilities, and improvement [in gait analysis] reflects real functional improvement,” said Dr. Otsuka of Shriners Hospitals for Children, Los Angeles.
Gait analysis is designed to provide objective, quantitative information about all aspects of gait, from overall walking to specific joint-related ranges of motion.
Children with cerebral palsy have shown improvement in gait analysis results following multilevel orthopedic surgery, but it has not been clear whether such improvements accurately reflect changes in function and quality of life.
In the study, 25 children with cerebral palsy underwent gait analysis and functional testing and participated in validated questionnaires preoperatively and at 1 year after multilevel lower extremity orthopedic surgery. The children, 8-16 years old, all had hip flexion contractures and were part of a larger trial of surgical techniques.
To make gait analysis results more easily interpretable, Dr. Otsuka and his colleagues used a summary gait analysis variable, called the “Normalcy Index,” which reflects the extent to which a child's gait deviates from the normal. The index is calculated from 16 kinematic and temporal parameters measured by gait analysis.
They compared the Normalcy Index with the total score for dimensions D (standing) and E (walking, running, jumping) of the Gross Motor Function Measure (GMFM), the walking score from the Gillette Functional Assessment Questionnaire (FAQ), and scores from the Pediatric Outcomes Data Collection Instrument (PODCI).
Results showed a strong correlation overall between the gait analysis Normalcy Index and the other scores, both before and after surgery, Dr. Otsuka said. Change in the Normalcy Index was most strongly correlated with change in the GMFM score; it did not correlate significantly with the PODCI score.