Further evidence of validity of the Gait Deviation Index

Abstract

In this paper, the relationship of the Gait Deviation Index (GDI) to gross motor function and its ability to distinguish between different Gross Motor Function Classification System (GMFCS) levels was determined. A representative sample of 184 ambulant children with CP in GMFCS levels I (n=57), II (n=91), III (n=22) and IV (n=14) were recruited as part of a population-based study. Representative gait cycles were selected following a 3D gait analysis and gross motor function was assessed using the Gross Motor Function Measure (GMFM). GDI scores were calculated in Matlab. Valid 3D kinematic data were obtained for 173 participants and both kinematic and GMFM data were obtained for 150 participants. A substantial relationship between mean GDI and GMFM-66 scores was demonstrated (r=0.70; p<0.001) with significant differences in mean GDI scores between GMFCS levels (p<0.001) indicating increasing levels of gait deviation in subjects less functionally able. The relationship between the GDI, GMFM and GMFCS in a representative sample of ambulators, lends further weight to the validity of the GDI scoring system. Furthermore it suggests that the subtleties of gait may not be wholly accounted for by gross motor function evaluation alone. Gait specific tools such as the GDI more likely capture both the functional and aesthetic components of walking.