Clinical efficacy of instrumented gait analysis: Systematic review 2020 update.
Decision making
Evidence
Gait analysis
Kinematics
Outcomes
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
10
03
2020
revised:
19
05
2020
accepted:
21
05
2020
pubmed:
22
6
2020
medline:
30
3
2021
entrez:
22
6
2020
Statut:
ppublish
Résumé
This paper updates our 2011 systematic review on the clinical efficacy of three-dimensional instrumented gait analysis (3DGA). What is the current evidence base pertaining to the clinical efficacy of 3DGA? We identified English language articles published from September 2009 to October 2019 reporting primary research that used typical motion analysis laboratory methods to study human walking. Five gait laboratory experts classified articles according to the highest type of efficacy they addressed: type 1 (technical), 2 (diagnostic accuracy), 2b (outcome prediction), 3-4 (diagnostic thinking and treatment), 5 (patient outcome), 6 (societal). Articles classified into type 3-4 and higher were rated for quality using LEGEND. Of 2712 articles related to the efficacy of 3DGA, over 99% addressed technical (n = 313), diagnostic (n = 1466), or outcome prediction (n = 927) efficacy. Six type 3-4 studies showed that 3DGA changes treatment plans, increases clinicians' confidence in their treatment decisions, and increases agreement among clinicians. Two type 5 articles based on a randomized controlled trial demonstrated that patient outcomes improved only when 3DGA data were available and its recommendations were followed. A population-based type 5 study found that the incidence of severe crouch gait dropped from 25% to 4% following practice changes including the addition of 3DGA. The strength of evidence was mainly 3b (lesser quality prospective cohort studies) but also included stronger studies (three level 2 controlled clinical trials). Literature related to the clinical efficacy of 3DGA has grown substantially over the last decade. Thousands of articles contribute to continued improvement of data collection and interpretation, as well as understanding of gait pathology and treatment. A smaller number of studies clearly demonstrate the efficacy of 3DGA in changing and reinforcing treatment decisions, increasing clinicians' confidence in treatment planning, and increasing agreement among clinicians, as well as the potential to improve patient outcomes.
Sections du résumé
BACKGROUND
This paper updates our 2011 systematic review on the clinical efficacy of three-dimensional instrumented gait analysis (3DGA).
RESEARCH QUESTION
What is the current evidence base pertaining to the clinical efficacy of 3DGA?
METHODS
We identified English language articles published from September 2009 to October 2019 reporting primary research that used typical motion analysis laboratory methods to study human walking. Five gait laboratory experts classified articles according to the highest type of efficacy they addressed: type 1 (technical), 2 (diagnostic accuracy), 2b (outcome prediction), 3-4 (diagnostic thinking and treatment), 5 (patient outcome), 6 (societal). Articles classified into type 3-4 and higher were rated for quality using LEGEND.
RESULTS
Of 2712 articles related to the efficacy of 3DGA, over 99% addressed technical (n = 313), diagnostic (n = 1466), or outcome prediction (n = 927) efficacy. Six type 3-4 studies showed that 3DGA changes treatment plans, increases clinicians' confidence in their treatment decisions, and increases agreement among clinicians. Two type 5 articles based on a randomized controlled trial demonstrated that patient outcomes improved only when 3DGA data were available and its recommendations were followed. A population-based type 5 study found that the incidence of severe crouch gait dropped from 25% to 4% following practice changes including the addition of 3DGA. The strength of evidence was mainly 3b (lesser quality prospective cohort studies) but also included stronger studies (three level 2 controlled clinical trials).
SIGNIFICANCE
Literature related to the clinical efficacy of 3DGA has grown substantially over the last decade. Thousands of articles contribute to continued improvement of data collection and interpretation, as well as understanding of gait pathology and treatment. A smaller number of studies clearly demonstrate the efficacy of 3DGA in changing and reinforcing treatment decisions, increasing clinicians' confidence in treatment planning, and increasing agreement among clinicians, as well as the potential to improve patient outcomes.
Identifiants
pubmed: 32563727
pii: S0966-6362(20)30181-8
doi: 10.1016/j.gaitpost.2020.05.031
pii:
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
274-279Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors have no conflicts of interest to declare.