Skip to main content
Top
Published in: Journal of Children's Orthopaedics 3/2016

Open Access 01-06-2016 | Original Clinical Article

Correlation between the Gait Deviation Index and gross motor function (GMFCS level) in children with cerebral palsy

Authors: Merete A. Malt, Ånen Aarli, Bård Bogen, Jonas M. Fevang

Published in: Journal of Children's Orthopaedics | Issue 3/2016

Login to get access

Abstract

Aim

The Gait Deviation Index (GDI) is a score derived from three-dimensional gait analysis (3DGA). The GDI provides a numerical value that expresses overall gait pathology (ranging from 0 to 100, where 100 indicates the absence of gait pathology). The aim of this study was to investigate the association between the GDI and different levels of gross motor function [defined as the Gross Motor Function Classification System (GMFCS)] and to explore if age, height, weight, gender and cerebral palsy (CP) subclass (bilateral and unilateral CP) exert any influence on the GDI in children with unilateral and bilateral spastic CP.

Methods

We calculated the GDI of 109 children [73 % boys, mean age 9.7 years (standard deviation, SD 3.5)] with spastic CP, classified at GMFCS levels I, II and III. Twenty-three normally developing children were used as controls [61 % boys, mean age 9.9 years (SD 2.6)]. Multiple linear regression analysis was performed.

Results

The mean GDI in the control group was 100 (SD 7.5). The mean GDI in the GMFCS level I group was 81 (SD 11), in the GMFCS level II group 71 (SD 11) and in the GMFCS level III group 60 (SD 9). Multiple linear regression analysis showed that gender, age and CP subclass had no significant correlation with the GDI, whereas height and weight had a slight impact.

Conclusion

This study showed a strong correlation between the GDI and GMFCS levels. The present data indicate that calculation of the GDI is a useful tool to characterise walking difficulties in children with spastic CP.
Literature
1.
go back to reference Gage JR (2012) Gait analysis in cerebral palsy, vol xv. Cambridge University Press, New York, 206 pp Gage JR (2012) Gait analysis in cerebral palsy, vol xv. Cambridge University Press, New York, 206 pp
2.
go back to reference Schwartz MH, Rozumalski A (2008) The Gait Deviation Index: a new comprehensive index of gait pathology. Gait Posture 28(3):351–357CrossRefPubMed Schwartz MH, Rozumalski A (2008) The Gait Deviation Index: a new comprehensive index of gait pathology. Gait Posture 28(3):351–357CrossRefPubMed
3.
go back to reference Hillman SJ, Hazlewood ME, Schwartz MH, van der Linden ML, Robb JE (2007) Correlation of the Edinburgh Gait Score with the Gillette Gait Index, the Gillette Functional Assessment Questionnaire, and dimensionless speed. J Pediatr Orthop 27(1):7–11CrossRefPubMed Hillman SJ, Hazlewood ME, Schwartz MH, van der Linden ML, Robb JE (2007) Correlation of the Edinburgh Gait Score with the Gillette Gait Index, the Gillette Functional Assessment Questionnaire, and dimensionless speed. J Pediatr Orthop 27(1):7–11CrossRefPubMed
4.
go back to reference Massaad A, Assi A, Skalli W, Ghanem I (2014) Repeatability and validation of gait deviation index in children: typically developing and cerebral palsy. Gait Posture 39(1):354–358CrossRefPubMed Massaad A, Assi A, Skalli W, Ghanem I (2014) Repeatability and validation of gait deviation index in children: typically developing and cerebral palsy. Gait Posture 39(1):354–358CrossRefPubMed
5.
go back to reference Molloy M, McDowell BC, Kerr C, Cosgrove AP (2010) Further evidence of validity of the Gait Deviation Index. Gait Posture 31(4):479–482CrossRefPubMed Molloy M, McDowell BC, Kerr C, Cosgrove AP (2010) Further evidence of validity of the Gait Deviation Index. Gait Posture 31(4):479–482CrossRefPubMed
6.
go back to reference Morano M, Colella D, Caroli M (2011) Gross motor skill performance in a sample of overweight and non-overweight preschool children. Int J Pediatr Obes 6(Suppl 2):42–46CrossRefPubMed Morano M, Colella D, Caroli M (2011) Gross motor skill performance in a sample of overweight and non-overweight preschool children. Int J Pediatr Obes 6(Suppl 2):42–46CrossRefPubMed
7.
go back to reference D’Hondt E, Deforche B, Vaeyens R, Vandorpe B, Vandendriessche J, Pion J et al (2011) Gross motor coordination in relation to weight status and age in 5- to 12-year-old boys and girls: a cross-sectional study. Int J Pediatr Obes 6(2–2):e556–e564CrossRefPubMed D’Hondt E, Deforche B, Vaeyens R, Vandorpe B, Vandendriessche J, Pion J et al (2011) Gross motor coordination in relation to weight status and age in 5- to 12-year-old boys and girls: a cross-sectional study. Int J Pediatr Obes 6(2–2):e556–e564CrossRefPubMed
8.
go back to reference Rutz E, Donath S, Tirosh O, Graham HK, Baker R (2013) Explaining the variability improvements in gait quality as a result of single event multi-level surgery in cerebral palsy. Gait Posture 38(3):455–460CrossRefPubMed Rutz E, Donath S, Tirosh O, Graham HK, Baker R (2013) Explaining the variability improvements in gait quality as a result of single event multi-level surgery in cerebral palsy. Gait Posture 38(3):455–460CrossRefPubMed
9.
go back to reference Cimolin V, Galli M, Tenore N, Albertini G, Crivellini M (2007) Gait strategy of uninvolved limb in children with spastic hemiplegia. Eur Medicophys 43(3):303–310 Cimolin V, Galli M, Tenore N, Albertini G, Crivellini M (2007) Gait strategy of uninvolved limb in children with spastic hemiplegia. Eur Medicophys 43(3):303–310
10.
go back to reference Stansfield BW, Hillman SJ, Hazlewood ME, Lawson AA, Mann AM, Loudon IR et al (2001) Normalized speed, not age, characterizes ground reaction force patterns in 5-to 12-year-old children walking at self-selected speeds. J Pediatr Orthop 21(3):395–402PubMed Stansfield BW, Hillman SJ, Hazlewood ME, Lawson AA, Mann AM, Loudon IR et al (2001) Normalized speed, not age, characterizes ground reaction force patterns in 5-to 12-year-old children walking at self-selected speeds. J Pediatr Orthop 21(3):395–402PubMed
11.
go back to reference Stansfield BW, Hillman SJ, Hazlewood ME, Lawson AA, Mann AM, Loudon IR et al (2001) Sagittal joint kinematics, moments, and powers are predominantly characterized by speed of progression, not age, in normal children. J Pediatr Orthop 21(3):403–411PubMed Stansfield BW, Hillman SJ, Hazlewood ME, Lawson AA, Mann AM, Loudon IR et al (2001) Sagittal joint kinematics, moments, and powers are predominantly characterized by speed of progression, not age, in normal children. J Pediatr Orthop 21(3):403–411PubMed
12.
go back to reference Schwartz MH, Rozumalski A, Trost JP (2008) The effect of walking speed on the gait of typically developing children. J Biomech 41(8):1639–1650CrossRefPubMed Schwartz MH, Rozumalski A, Trost JP (2008) The effect of walking speed on the gait of typically developing children. J Biomech 41(8):1639–1650CrossRefPubMed
13.
go back to reference Rosenbaum PL, Walter SD, Hanna SE, Palisano RJ, Russell DJ, Raina P et al (2002) Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA 288(11):1357–1363CrossRefPubMed Rosenbaum PL, Walter SD, Hanna SE, Palisano RJ, Russell DJ, Raina P et al (2002) Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA 288(11):1357–1363CrossRefPubMed
14.
go back to reference Hanna SE, Rosenbaum PL, Bartlett DJ, Palisano RJ, Walter SD, Avery L et al (2009) Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years. Dev Med Child Neurol 51(4):295–302CrossRefPubMed Hanna SE, Rosenbaum PL, Bartlett DJ, Palisano RJ, Walter SD, Avery L et al (2009) Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years. Dev Med Child Neurol 51(4):295–302CrossRefPubMed
15.
go back to reference Chounti A, Hägglund G, Wagner P, Westbom L (2013) Sex differences in cerebral palsy incidence and functional ability: a total population study. Acta Paediatr 102(7):712–717CrossRefPubMed Chounti A, Hägglund G, Wagner P, Westbom L (2013) Sex differences in cerebral palsy incidence and functional ability: a total population study. Acta Paediatr 102(7):712–717CrossRefPubMed
16.
go back to reference Winters TF Jr, Gage JR, Hicks R (1987) Gait patterns in spastic hemiplegia in children and young adults. J Bone Joint Surg Am 69(3):437–441PubMed Winters TF Jr, Gage JR, Hicks R (1987) Gait patterns in spastic hemiplegia in children and young adults. J Bone Joint Surg Am 69(3):437–441PubMed
17.
go back to reference Rodda JM, Graham HK, Carson L, Galea MP, Wolfe R (2004) Sagittal gait patterns in spastic diplegia. J Bone Joint Surg Br 86(2):251–258CrossRefPubMed Rodda JM, Graham HK, Carson L, Galea MP, Wolfe R (2004) Sagittal gait patterns in spastic diplegia. J Bone Joint Surg Br 86(2):251–258CrossRefPubMed
Metadata
Title
Correlation between the Gait Deviation Index and gross motor function (GMFCS level) in children with cerebral palsy
Authors
Merete A. Malt
Ånen Aarli
Bård Bogen
Jonas M. Fevang
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
Journal of Children's Orthopaedics / Issue 3/2016
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-016-0738-4

Other articles of this Issue 3/2016

Journal of Children's Orthopaedics 3/2016 Go to the issue