Parental subjective assessment of gait limitations: Comparison with objective gait variables.
Balance
Cerebral palsy
Clinical gait analysis
GMFCS level, Subjective assessment
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
05
08
2021
revised:
16
11
2021
accepted:
28
11
2021
pubmed:
7
12
2021
medline:
15
3
2022
entrez:
6
12
2021
Statut:
ppublish
Résumé
Subjective assessment is an important part of clinical examination providing quality insights into impairments of body structure and functions. Research into the associations between parental perceptions of gait in children with cerebral palsy (CP) and objective clinical gait measures is limited. What are the parental perceived gait limitations in children with CP and are these perceptions associated with objective clinical gait analysis? Parent questionnaires were retrospectively analysed for children with CP who attended our gait analysis laboratory over a 24-month period. Perceived walking limitations caused by pain, weakness, lack of endurance, mental ability, safety concerns, and balance were recorded on a 5-point Likert scale. Normalised gait speed, normalised step length and the Gait Deviation Index (GDI) were calculated. Differences between responses were assessed using Chi-squared tests with Dunn's post hoc test with Bonferroni adjustment. Spearman's rank correlations were performed to determine the relationship between responses and gait parameters. Data from 251 participants were included, mean age 9 ± 3.4 years, Gross Motor Function Classification System (GMFCS) level I = 158, II = 64 and III = 29. Balance was perceived to limit walking to the greatest extent, followed by weakness, lack of endurance, safety concerns, pain and mental ability. This rank was consistent across GMFCS levels I, II and III. Perceived balance limitations showed the strongest correlations with objective gait variables, GDI (r = -0.31 p = 0.000), normalised step length (r = -0.30 p = 0.0000) and normalised gait speed (r = -0.24 p = 0.0001). Subjective gait perceptions provide a valuable indication of gait function but are weakly associated with objective clinical gait analysis. Outcome measures that are sensitive to changes in balance may be more responsive to parental concerns and help to satisfy their goals and expectations.
Sections du résumé
BACKGROUND
Subjective assessment is an important part of clinical examination providing quality insights into impairments of body structure and functions. Research into the associations between parental perceptions of gait in children with cerebral palsy (CP) and objective clinical gait measures is limited.
RESEARCH QUESTION
What are the parental perceived gait limitations in children with CP and are these perceptions associated with objective clinical gait analysis?
METHODS
Parent questionnaires were retrospectively analysed for children with CP who attended our gait analysis laboratory over a 24-month period. Perceived walking limitations caused by pain, weakness, lack of endurance, mental ability, safety concerns, and balance were recorded on a 5-point Likert scale. Normalised gait speed, normalised step length and the Gait Deviation Index (GDI) were calculated. Differences between responses were assessed using Chi-squared tests with Dunn's post hoc test with Bonferroni adjustment. Spearman's rank correlations were performed to determine the relationship between responses and gait parameters.
RESULTS
Data from 251 participants were included, mean age 9 ± 3.4 years, Gross Motor Function Classification System (GMFCS) level I = 158, II = 64 and III = 29. Balance was perceived to limit walking to the greatest extent, followed by weakness, lack of endurance, safety concerns, pain and mental ability. This rank was consistent across GMFCS levels I, II and III. Perceived balance limitations showed the strongest correlations with objective gait variables, GDI (r = -0.31 p = 0.000), normalised step length (r = -0.30 p = 0.0000) and normalised gait speed (r = -0.24 p = 0.0001).
SIGNIFICANCE
Subjective gait perceptions provide a valuable indication of gait function but are weakly associated with objective clinical gait analysis. Outcome measures that are sensitive to changes in balance may be more responsive to parental concerns and help to satisfy their goals and expectations.
Identifiants
pubmed: 34871926
pii: S0966-6362(21)00622-6
doi: 10.1016/j.gaitpost.2021.11.039
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
218-222Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.