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Open Access Research article

Reliability of videotaped observational gait analysis in patients with orthopedic impairments

Jaap J Brunnekreef1, Caro JT van Uden123*, Steven van Moorsel1 and Jan GM Kooloos4

Author Affiliations

1 Department of Physical Therapy, Radboud University Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands

2 Department of Integrated Care, Research Institute Caphri, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands

3 Department of General Practice, Research Institute Caphri, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands

4 Department of Anatomy and Embryology, Radboud University Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands

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BMC Musculoskeletal Disorders 2005, 6:17  doi:10.1186/1471-2474-6-17

Published: 17 March 2005

Abstract

Background

In clinical practice, visual gait observation is often used to determine gait disorders and to evaluate treatment. Several reliability studies on observational gait analysis have been described in the literature and generally showed moderate reliability. However, patients with orthopedic disorders have received little attention. The objective of this study is to determine the reliability levels of visual observation of gait in patients with orthopedic disorders.

Methods

The gait of thirty patients referred to a physical therapist for gait treatment was videotaped. Ten raters, 4 experienced, 4 inexperienced and 2 experts, individually evaluated these videotaped gait patterns of the patients twice, by using a structured gait analysis form. Reliability levels were established by calculating the Intraclass Correlation Coefficient (ICC), using a two-way random design and based on absolute agreement.

Results

The inter-rater reliability among experienced raters (ICC = 0.42; 95%CI: 0.38–0.46) was comparable to that of the inexperienced raters (ICC = 0.40; 95%CI: 0.36–0.44). The expert raters reached a higher inter-rater reliability level (ICC = 0.54; 95%CI: 0.48–0.60). The average intra-rater reliability of the experienced raters was 0.63 (ICCs ranging from 0.57 to 0.70). The inexperienced raters reached an average intra-rater reliability of 0.57 (ICCs ranging from 0.52 to 0.62). The two expert raters attained ICC values of 0.70 and 0.74 respectively.

Conclusion

Structured visual gait observation by use of a gait analysis form as described in this study was found to be moderately reliable. Clinical experience appears to increase the reliability of visual gait analysis.