Elsevier

Gait & Posture

Volume 41, Issue 2, February 2015, Pages 741-743
Gait & Posture

Short Communication
The relationship between the Edinburgh Visual Gait Score, the Gait Profile Score and GMFCS levels I–III

https://doi.org/10.1016/j.gaitpost.2015.01.022Get rights and content

Highlights

  • The Edinburgh Visual Gait Score correlated strongly with the Gait Profile Score.

  • There is a significant difference in EVGS between each level of the GMFCS (I–III).

  • There is a significant difference in GPS between each level of the GMFCS (I–III).

  • Kinematics, including the GPS, remains the gold-standard in gait analysis.

Abstract

Objective

To determine the relationship between the Edinburgh Visual Gait Score (EVGS) and the Gait Profile Score (GPS).

Method

Three dimensional gait data and EVGS scores from 151 diplegic children (Gross Motor Function Classification System (GMFCS) levels I–III) were used for analysis.

Results

The EVGS correlated strongly with GPS (r = 0.816). There was a significant difference in both gait scores between each level of the GMFCS.

Conclusions

The strong correlation of GPS with EVGS implies that any advantages of using GPS can also be applied to centres without 3-dimensional gait analysis facilities if the EVGS is used.

Introduction

Baker et al. [1] recently described the Gait Profile Score (GPS), a summary measure based on the root mean square difference between the kinematic output of a pathological gait and a normal gait average. The GPS has been validated as an effective measure of gait quality [2] and is responsive to changes after surgery [3]. It has been shown to correlate with experienced clinicians’ clinical judgement on gait abnormalities [4] and its frequency distribution across different Gross Motor Function Classification System (GMFCS) levels has been demonstrated [3]. The GPS can be decomposed into nine kinematic variables termed the Gait Variable Scores (GVS), which describe the magnitude of deviation of these nine variables across the gait cycle [1].

The Edinburgh Visual Gait Score (EVGS) [5] consists of seventeen items and is based on the visual observation of gait in the sagittal and coronal planes. It has been validated for use by experienced and inexperienced observers, [6] has good concurrent validity with other assessments [7] and is reliable [8].

The first aim of this study was to determine the relationship between GPS and EVGS and secondly to correlate the relationship between GMFCS levels and the EVGS which has not been reported previously. Our first hypothesis was that there would be a poor correlation between GPS and EVGS because one is derived from 3-dimensional gait analysis (3DGA) and the other from observational gait analysis using a video recorder. The second hypothesis was that there would be a significant difference between EVGS at each GMFCS level because increasing severity of cerebral palsy would be reflected by a higher GMFCS level and therefore a higher EVGS.

Section snippets

Methods

Data were retrospectively collected on all patients with diplegic cerebral palsy, GMFCS levels I–III, who had attended our CMAS (Clinical Movement Analysis Society, UK) accredited laboratory for at least one session of gait analysis, between 2007 and November 2013. Three dimensional gait data, EVGS scores, and GMFCS level were recorded for the most recent gait analysis session. Data were extracted for 151 patients, mean age 13.3 years. Each gait analysis session produces three trials; a single

Results

The EVGS correlated strongly with GPS (PPMCC 0.815, r2 0.664, p < 0.0001, Fig. 1).

There was a significant difference in the EVGS between each level of GMFCS and the same was observed for the GPS, with an increasing score being associated with an increase in the GMFCS level (Table 1).

Discussion

The first outcome of this study was demonstration of a strong correlation between EVGS and GPS in spite of the different derivation of the two scores. The GPS can be decomposed into nine kinematic variables across the gait cycle and the EVGS into 17 items, some of which are swing phase events and the remainder stance phase events (Table 2). They share six items in common but these are derived from instrumented gait analysis on the one hand and from visual observation of gait on the other. Gait

Conflict of interest

The authors declare no conflict of interests.

Cited by (21)

  • Three decades of gait index development: A comparative review of clinical and research gait indices

    2022, Clinical Biomechanics
    Citation Excerpt :

    Similarly, EVGS, which is already popular amongst clinicians, has been validated and used with younger children, adolescents, and adults (Cretual et al., 2010; del Pilar Duque Orozco et al., 2016; Gupta and Raja, 2012; MacFarlane et al., 2020; Ong et al., 2008; Oudenhoven et al., 2019; Uzun Akkaya and Elbasan, 2021; van Schie et al., 2005) making it of clinical relevance as it can be used to assess patients over the long-term. EVGS has shown good correlations with the kinematic- (GGI, GDI and GPS) (Cretual et al., 2010; Robinson et al., 2017, 2015; Sardogan et al., 2020) and electromyography-based (KeR-EGI) indices (Bervet et al., 2013), maintaining its relevance in research settings. The use of EVGS in tandem with kinematic and electromyographic based indices allows for the most comprehensive data of a patient’s gait.

  • Intra-rater and inter-rater reliability, minimal detectable change, and construct validity of the Edinburgh Visual Gait Score in children with cerebral palsy

    2022, Gait and Posture
    Citation Excerpt :

    The hypothesis testing examines whether an assessment score is consistent with hypotheses based on the assumption that it is a valid measure of the construct to be measured [25,26]. We hypothesized that gross motor function is one of the components of gait patterns based on the correlation of the EVGS with the GMFCS [13,14] and the FAQ [14,15]. The relationship between the EVGS and the GMFM-66 is a stronger correlation than the relationships between the EVGS and the GMFCS or the FAQ.

  • Correlations between the Gait Profile Score and standard clinical outcome measures in children with idiopathic clubfoot

    2019, Gait and Posture
    Citation Excerpt :

    While both are measures of gait deviation, the item walking in CAP evaluates deviations mainly at foot level while GPS/GVS is based on deviations measured at the foot, knee, hip and pelvic levels (Table 1) [14,17]. One study [19] found strong significant correlations between the Edinburgh Visual Gait Score and GPS in children with CP. That study tested more parameters and used a broader scale.

  • Factors Associated With Long-Term Improvement of Gait After Selective Dorsal Rhizotomy

    2019, Archives of Physical Medicine and Rehabilitation
    Citation Excerpt :

    Another limitation of this study was the use of 2-dimensional clinical gait analysis. Although good reliability of the EVGS score has been reported previously,20,21,25 several children walked with rotations and motion out of the sagittal plane was likely to occur. In addition, our results are restricted to effects on gait quality and do not include functional capacity or quality of daily life.

View all citing articles on Scopus
View full text