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Accuracy and Reliability of Observational Gait Analysis Data: Judgments of Push-off in Gait After Stroke

JL McGinley, PT, BAppSc (PT), is a doctoral student in the School of Physiotherapy, La Trobe University, Victoria, Australia, and Senior Research Physical Therapist, Geriatric Research Unit, Kingston Centre Rehabilitation and Aged Services Program, Southern Health, Melbourne, Australia.
PA Goldie, PT, PhD, is Associate Professor, School of Physiotherapy, La Trobe University
KM Greenwood, PhD, is Associate Professor, School of Psychological Science, La Trobe University
SJ Olney, PhD, is Professor and Director, School of Rehabilitation Therapy, and Associate Dean (Health Sciences), Queen's University, Kingston, Ontario, Canada

Address all correspondence to Ms McGinley at Geriatric Research Unit, Kingston Centre, Warrigal Rd, Cheltenham, Victoria, Australia 3192 (j.mcginley{at}latrobe.edu.au)

Background and Purpose. Physical therapists routinely observe gait in clinical practice. The purpose of this study was to determine the accuracy and reliability of observational assessments of push-off in gait after stroke. Subjects. Eighteen physical therapists and 11 subjects with hemiplegia following a stroke participated in the study. Method. Measurements of ankle power generation were obtained from subjects following stroke using a gait analysis system. Concurrent videotaped gait performances were observed by the physical therapists on 2 occasions. Ankle power generation at push-off was scored as either normal or abnormal using two 11-point rating scales. These observational ratings were correlated with the measurements of peak ankle power generation. Results. A high correlation was obtained between the observational ratings and the measurements of ankle power generation (mean Pearson r=.84). Interobserver reliability was moderately high (mean intraclass correlation coefficient [ICC (2,1)]=.76). Intraobserver reliability also was high, with a mean ICC (2,1) of .89 obtained. Discussion and Conclusion. Physical therapists were able to make accurate and reliable judgments of push-off in videotaped gait of subjects following stroke using observational assessment. Further research is indicated to explore the accuracy and reliability of data obtained with observational gait analysis as it occurs in clinical practice.

Key Words: Accuracy • Gait • Observational assessment • Reliability • Validity

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