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Gait in Children With Cerebral Palsy: Observer Reliability of Physician Rating Scale and Edinburgh Visual Gait Analysis Interval Testing Scale

Maathuis, Karel G. B MD, PhD*†; van der Schans, Cees P PhD; van Iperen, Andries MD*; Rietman, Hans S MD*†; Geertzen, Jan H. B MD, PhD*†

Journal of Pediatric Orthopaedics: May-June 2005 - Volume 25 - Issue 3 - p 268-272
doi: 10.1097/01.bpo.0000151061.92850.74
Neuromuscular: Original Article

The aim of this study was to test the inter- and intraobserver reliability of the Physician Rating Scale (PRS) and the Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale for use in children with cerebral palsy (CP). Both assessment scales are quantitative observational scales, evaluating gait. The study involved 24 patients ages 3 to 10 years (mean age 6.7 years) with an abnormal gait caused by CP. They were all able to walk independently with or without walking aids. Of the children 15 had spastic diplegia and 9 had spastic hemiplegia. With a minimum time interval of 6 weeks, video recordings of the gait of these 24 patients were scored twice by three independent observers using the PRS and the GAIT scale. The study showed that both the GAIT scale and the PRS had excellent intraobserver reliability but poor interobserver reliability for children with CP. In the total scores of the GAIT scale and the PRS, the three observers showed systematic differences. Consequently, the authors recommend that longitudinal assessments of a patient should be done by one observer only.

From the *Centre for Rehabilitation University Hospital, Groningen, The Netherlands; †Northern Centre for Health Care Research, University Groningen, The Netherlands; and ‡University for Professional Education, Hanzehogeschool, Groningen, The Netherlands.

Study conducted at the Department of Rehabilitation, University Hospital Groningen, Groningen, The Netherlands.

None of the authors received financial support for this study.

Reprints: Karel G. B. Maathuis, MD, PhD, Department of Rehabilitation, University Hospital Groningen, Hanzeplein 1, P. O. Box 30.001, 9700 RB, Groningen, the Netherlands (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.