Elsevier

Gait & Posture

Volume 7, Issue 2, March 1998, Pages 125-130
Gait & Posture

Technical Note
Retest reliability of spatiotemporal gait parameters in children and adults

https://doi.org/10.1016/S0966-6362(97)00043-XGet rights and content

Abstract

The objective of the study was to assess the retest-reliability of ten different gait parameters in healthy children (n=12; age 6–7 years) and adults (n=12; age 21–35 years) during free-speed locomotion on a simple walkway. Further the intra-subject variability of the stride dimensions was checked. On two occasions, spatial gait parameters were measured by footprint analysis, temporal dimensions were recorded using video-analysis. For spatial gait parameters, correlation coefficients (ICC, Pearson's r) between the test and the retest results were found to be high in adults and satisfying in children. The temporal parameters were less consistent. Generally the within-trial variability was higher in children than in adults. Conclusions: (i) The retest reliability for the measurement of the spatial gait parameters can be judged as high. (ii) For gait analysis in children it should be taken into account that gait parameters are more variable from trial to trial than in adults.

Introduction

Spatiotemporal gait parameters such as gait velocity, stride length, cadence, step width and foot rotation angles are simple and inexpensive to measure and provide the basic data characterizing a subject's gait. They have been used to evaluate the development of walking in children 1, 2, 3, 4, 5, 6, gait disorders and normal adult locomotion 7, 8, 9, 10, frequently supplemented by kinematic, kinetic and EMG data. Gait parameters are usually measured in one test session at the subject's self-selected walking speed (free-speed locomotion), based on the assumption that data from a single evaluation are representative enough to characterize an individual's gait performance [11].

This presumption should be proven by evaluating the repeatability of the basic gait variables in a test-retest comparison, since the walking pattern might vary between days. Some previous studies have assessed the retest reliability of gait parameters in adults, which was found to be high for most of the investigated parameters 11, 12, 13. Equivalent studies in children are lacking so far. Young subjects display less stereotyped kinematic patterns during repetitive movements [14]and can be distracted more easily during a test situation than adults. This could result in a lower repeatability of spatiotemporal gait measurements. Moreover, the test-retest reliability of basic balance-related gait parameters such as step width (i.e. dynamic base [4]) and foot rotation angles has not yet been analyzed systematically. Therefore the present study was performed to evaluate the retest reliability of balance-related and other spatiotemporal gait parameters in children which were sampled on two different days. The intertrial differences were compared to the within-day variability. To detect age-dependent differences, a group of healthy adults was investigated correspondingly.

Section snippets

Subjects

Two groups of healthy subjects were investigated. Twelve children (six girls and six boys) with an average age of 6.8 years (S.D.=0.4) and 12 adults (six women, six men) with a mean age of 27.5 years (S.D.=5.2) participated in the study. All adult subjects and the parents of the children gave their informed consent prior to participation. In addition, the children assented to the testing. The adults were recruited from students and the staff of the Department, the children from primary schools.

Retest-reliability in children and adults

Original data of a 7-year-old boy, illustrating the step to step variability and the resulting mean test and retest values of four independent gait parameters are illustrated in Fig. 2 as a representative example. In the retest, the child walked faster with a greater mean step length than in the test, and the mean step width and foot rotation angle decreased somewhat (Δ in Fig. 2). To provide a more comprehensive intertrial comparison, the averaged test and retest results (intersubject

Discussion

The method of footprint analysis used in this study is inexpensive, easy to apply and does not interfere with the natural movements. The thin metal plates attached to the shoes are not perceivable for the subjects. From the imprinted footsteps the spatial gait parameters can be measured directly; the accuracy is about 1 mm for the step length and width and around one degree for the foot rotation angle. This approach ensures reliable measurements and consequently a high interobserver

Acknowledgements

This work was supported by Grant No. 01 KO 9511 from the Ministerium für Bildung und Forschung, Bonn, Germany. The authors are indebted to Mrs. Sybille van der Horst and to Mr. Matthias Kriest for their excellent technical assistance.

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