1st Joint ESMAC-GCMAS Meeting - Análise de Marcha

Results
The additional criterion of reduced DF range in swing resulted in 45 children being classified
as Type Ib and the absence of first rocker resulted in 15 children being classified as Type Ia
(Table 1). These changes to the original algorithm resulted in 93% of the hemiplegic
population being classified. Visual observation of the video and kinematic data of the six
remaining ‘unclassified’ individuals revealed no deviations from normal.
Table 1. Numbers of participants classified using original and refined automated classification system
Classification Original system Revised system (%)
Type IV 8 (9.5%) 8 (9.5%)
Type III 6 (7.1%) 6 (7.1%)
Type II 4 (4.8%) 4 (4.8%)
Type I 31 (36.9%)
Type Ib 45 (53.6%)
Type Ia 15 (17.9%)
Unclassified/normal gait 35 (41.7%) 6 (7.1%)
Discussion
This study has demonstrated that the classification of hemiplegic walking patterns in a total
population is possible without visual confirmation. The original algorithm classified children
as Type I if they failed to achieve DF>0degrees in swing, however the addition of a reduced
DF range to this criteria facilitated the classification of a further 14 children. This perhaps
more accurately reflects the work of Winters and Gage [2] who identified but did not define
reduced DF in swing in Type I hemiplegic gait. Further modification of the system using the
absence of 1 st rocker (Type Ia) allowed classification of almost the entire population. The
results of the application of the algorithm to a total population of children with hemiplegia
suggests that many children have mild deviations from normal walking patterns that may be
difficult to observe clinically.
This automated procedure can detect subtle deviations from normal and removes bias that can
be difficult to eliminate from visual diagnosis. This tool may be particularly useful when
evaluating large clinic or population-based samples. However it is important to note that
ultimately this procedure applies discrete values to continuous data and thus some children
may, over a series of different gait cycles, satisfy the criteria for inclusion in two groups. The
reliability of the system in these instances has been satisfactorily evaluated and is presented
elsewhere.
Acknowledgements
We would like to thank all the families that participated in the project and acknowledge the
support of the Northern Ireland Research and Development Office, Project Grant
RSG/1708/01.
References
[1] Kelly C, Kerr C, McDowell B, Cosgrove A. (2005) Proceedings of 14 th Annual Meeting of the European
Society of Movement Analysis in Adults and Children.
[2] Winters TF, Gage JR, Hicks R. (1987) The Journal of Bone and Joint Surgery 69: 437-441.
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