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Y. Salem1,2, R. States3, E. Godwin3, L. Hoffecker4, J. Krzak5, M. McMulkin6, A. Bodkin7
1Unversity of North Texas Health Science Center, Fort Worth, United States, 2Cairo University, Faculty of Physical Therapy, Cairo, Egypt, 3Long Island University, Brooklyn, United States, 4Univeristy of Colorado, Denver, United States, 5Midwestern University, Downers Grove, United States, 6Shriners Hospitals for Children-Spokane, Spokane, United States, 7Children’s Hospital Colorado, Denver, United States
Background: Instrumented gait analysis (IGA) is a critical tool for managing children with gait dysfunctions related to cerebral palsy (CP). Due to its multi-faceted nature and continuing technical developments over the past 50 years, there are myriad approaches to collection and application of IGA data. This scoping review was undertaken in preparation for development of a clinical practice guideline (CPG) to address these topics.
Purpose: The purpose of this scoping review was to identify and categorize the evidence about use of IGA in the clinical management of children with CP.
Methods: A health sciences librarian developed the search strategy with 4 key inclusion criteria:
a) original peer-reviewed research study;
b) included children with CP;
c) used IGA to investigate gait; and
d) available in English.
Medline and other databases were searched in December 2019. Abstracts were screened by individual authors. Included studies were classified into 6 categories using basic design elements of each study based on Wren et al.’s 2011 systematic review about IGA. To ensure reliability of screening and categorization, 100% agreement across the 6 authors was achieved for sets of 10 abstracts and full-text articles.
a) original peer-reviewed research study;
b) included children with CP;
c) used IGA to investigate gait; and
d) available in English.
Medline and other databases were searched in December 2019. Abstracts were screened by individual authors. Included studies were classified into 6 categories using basic design elements of each study based on Wren et al.’s 2011 systematic review about IGA. To ensure reliability of screening and categorization, 100% agreement across the 6 authors was achieved for sets of 10 abstracts and full-text articles.
Results: 1285 citations were screened; 529 studies met inclusion criteria and were categorized. Methodological studies (Category 1) and studies that identified atypical gait characteristics or diagnostic subgroups (Category 2) comprised 263 (50%) of included studies. Their average sample size was 103 participants, 151 were prospective, 217 used cross-sectional designs. For the 23 studies investigating whether using IGA generated direct clinical or cost benefits (Categories 3, 4, 5), average sample size was 109 participants,17 were prospective. For studies using IGA as an outcome measure to evaluate non-IGA interventions, average sample size was 38 participants,147 were prospective.
Conclusion(s): This scoping review identified and categorized the spectrum of peer-reviewed research on IGA for children with gait dysfunction related to CP. As such it forms the basis for developing a CPG about the use of IGA for the clinical management of children with CP. Additional steps such as stakeholder surveys, development of precise PICO(T) questions for the CPG, quality assessment of studies, and meta-analysis where feasible, are progressing.
Implications: This scoping review can help clinicians and researchers understand the role of IGA in clinical decision making for children with CP related gait dysfunction by discriminating amongst the wide range of IGA approaches to the examination, evaluation, and measurement of gait dysfunction in children with CP.
Funding, acknowledgements: None
Keywords: Gait Analysis, Cerebral Palsy, Systematic Review
Topic: Paediatrics
Did this work require ethics approval? No
Institution: No IRB required
Committee: N/A
Reason: This is a scoping review. No Ethical approval is required for scoping reviews. No Data collection on individual participants.
All authors, affiliations and abstracts have been published as submitted.
