Objective: This study aimed to investigate levels of validity, and inter- and intra-observer reliability of observational gait analysis (OGA) in clinical usage, done by the physical therapists with varying clinical experience, in subjects with knee osteoarthritis.Methods: The study included 33 subjects (22 female, 11 male; mean age: 58.24±9.14 years range: 46 to 81) clinically and radiographically diagnosed with bilateral knee osteoarthritis, and 4 physical therapists to observe the subjects' gaits. The physical therapists were separated into two groups according to their professional experience: those with 10 or more years, and those with fewer than 10 years. Video recordings were made of the subjects undergoing three-dimensional gait analysis (3DGA). These recordings were then observationally assessed twice by the participating physical therapists with at least a 6-week interval between observations. OGA was done via a form comprising 11 kinematic and 5 temporo-spatial parameters.Results: Lowest levels of agreement in both validity (r=0.06, p>0.05), and inter- (ICC:-0.12-0.06) and intra-observer (ICC:0.30-0.45) reliability were found in the parameters of ankle dorsiflexion in initial contact phase and pelvic rotation in midstance phase. Highest inter- and intra-observer agreement was found in the temporo-spatial parameters of step width, double step length, cadence and velocity (ICC:0.61-0.80). Highest validity was found in pelvic tilt in stance phase (r=0.74-0.78, p<0.001). With the exception of stance phase, moderate or good agreement (r=0.52-0.69, p<0.05) was found in the temporo-spatial parameters.Conclusion: This study found that OGA assessment of temporo-spatial parameters had moderate or good validity and reliability. Assessment of the majority of kinematic parameters had fair or moderate validity and inter-observer reliabilty, and moderate or good intra-observer reliability
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Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev 1988;10:1-28.
Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Bio- mechanical changes at the hip, knee, and ankle joints dur- ing gait are associated with knee osteoarthritis severity. J Orthop Res 2008;26:332-41.
Nagano Y, Naito K, Saho Y, Torii S, Ogata T, Nakazawa K, et al. Association between in vivo knee kinematics during gait and the severity of knee osteoarthritis. Knee 2012;19:628-32.
Kopf A, Pawelka S, Kranzl A. Clinical gait analysis-meth- ods, limitations and possible applications. [Article in Ger- man] Acta Med Austriaca 1998;25:27-32. [Abstract]
McGinley JL, Goldie PA, Greenwood KM, Olney SJ. Ac- curacy and reliability of observational gait analysis data: judgments of push-off in gait after stroke. Phys Ther 2003;83:146-60.
Mackey AH, Lobb GL, Walt SE, Stott NS. Reliability and validity of the Observational Gait Scale in children with spastic diplegia. Dev Med Child Neurol 2003;45:4-11.
Toro B, Nester CJ, Farren PC. Inter- and intraobserver repeatability of the Salford Gait Tool: an observation- based clinical gait assessment tool. Arch Phys Med Rehabil 2007;88:328-32.
Viehweger E, Zürcher Pfund L, Hélix M, Rohon MA, Jac- quemier M, Scavarda D, et al. Influence of clinical and gait analysis experience on reliability of observational gait anal- ysis (Edinburgh Gait Score Reliability). Ann Phys Rehabil Med 2010;53:535-46.
Ong AM, Hillman SJ, Robb JE. Reliability and valid- ity of the Edinburgh Visual Gait Score for cerebral palsy when used by inexperienced observers. Gait Posture 2008;28:323-6.
Williams G, Morris ME, Schache A, McCrory P. Obser- vational gait analysis in traumatic brain injury: accuracy of clinical judgment. Gait Posture 2009;29:454-9.
Field-Fote EC, Fluet GG, Schafer SD, Schneider EM, Smith R, Downey PA, et al. The Spinal Cord Injury Func- tional Ambulation Inventory (SCI-FAI). J Rehabil Med 2001;33:177-81.
Brunnekreef JJ, van Uden CJ, van Moorsel S, Kooloos JG. Reliability of videotaped observational gait analysis in pa- tients with orthopedic impairments. BMC Musculoskelet Disord 2005;6:17.
Eastlack ME, Arvidson J, Snyder-Mackler L, Danoff JV, McGarvey CL. Interrater reliability of videotaped observa- tional gait-analysis assessments. Phys Ther 1991;71:465- 72.
Kirtley C. Clinical gait analysis: theory and practice. Edin- burgh: Elsevier Churchill Livingstone; 2006.
Perry J. Gait analysis normal and pathological function. Thorofare, New Jersey: Slack; 1992.
Whitttle, M. Gait Analysis: an introduction. Edinburgh: Butterworth-Heinemann; 2007.
Kawamura CM, de Morais Filho MC, Barreto MM, de Paula Asa SK, Juliano Y, Novo NF. Comparison between visual and three-dimensional gait analysis in patients with spastic diplegic cerebral palsy. Gait Posture 2007;25:18- 24.
Schmid S, Schweizer K, Romkes J, Lorenzetti S, Brunner R. Secondary gait deviations in patients with and without neurological involvement: a systematic review. Gait Posture 2013;37:480-93.
Opheim A, McGinley JL, Olsson E, Stanghelle JK, Jahnsen R. Walking deterioration and gait analysis in adults with spastic bilateral cerebral palsy. Gait Posture 2013;37:165- 71.
Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. J Electromyogr Kinesiol 2011;21:695-703.
Martin K, Hoover D, Wagoner E, Wingler T, Evans T, O'Brien J, et al. Development and reliability of an observa- tional gait analysis tool for children with Down syndrome. Pediatr Phys Ther 2009;21:261-8.
Brown CR, Hillman SJ, Richardson AM, Herman JL, Robb JE. Reliability and validity of the Visual Gait As- sessment Scale for children with hemiplegic cerebral palsy when used by experienced and inexperienced observers. Gait Posture 2008;27:648-52.