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Background: The Gait Deviation Index (GDI) and the Gait Profile Score (GPS) are the most used scores to sum up gait deviations and are used as primary outcomes in many clinical studies. They are considered as equivalent scores. The computation of these scores is based on a reference dataset but often no description is provided. Among other characteristics, the number of observations needed and its possible influence on the computation of the scores remains unknown.Research Question: Define the number of observations needed in the reference dataset to compute consistent and reliable GDI and GPS.Methods: Fifty individuals with cerebral palsy (CP) were randomly selected from our laboratory database. Both scores were computed based on the reference dataset of Schwartz et al. (2008). A bootstrap analysis was performed, for every individual, to assess the effect of the number of observations on both scores. N number of observations were randomly selected, with replacement, from the reference dataset. This procedure was repeated 2000 times for every individual and every N and performed from N = 5 to N = 165 with an increment of 5. The 95 % of the absolute error distribution was considered for every individual and every N. The smallest detectable change (SDC) for both scores was considered as a threshold (GDI: 10.8; GPS:1.3°) to determine the minimum N required.Results and Significance: A minimum of 90 and 20 observations are required to compute consistent GDI and GPS, respectively. The number of observations has a higher impact on the GDI than the GPS, mainly because the GPS calculation does not rely on the standard deviation (SD). Furthermore, the GDI absolute error seems to be higher in individuals with greater gait deviations, i.e. lower GDI value. This effect was not observed on the GPS. In the case of a small reference dataset, the GPS should therefore be preferred. [ABSTRACT FROM AUTHOR]

Idiopathic toe walking (ITW) refers to a condition where a person persistently walks on their toes after the age of 5 years, without any underlying neurological or orthopedic abnormalities (1-3). ITW can lead to various issues such as pain in the feet and/or calfs, skeletal deformities,and increased risk of falls (4). The treatments for ITW depend on the severity of the equinus (toe walking) and may include conservative such as casts or orthoses, or surgical treatments such as gastrocnemius recession or tendo-achilles lengthening. However, there is currently no consensus on the optimal treatment for patients with ITW (5, 6). The aims of this study were: 1) to observe gait parameters evolution for a group of patients with surgery and conservative treatment; 2) to compare these parameters for a group of matched patients with surgery and without; 3) to compare these parameters with a group of asymptomatic children. ITW patients with surgical or conservative treatment and with at least one clinical gait analysis (CGA) before and after treatment were selected in the database of the Willy Taillard Kinesiology laboratory. Gait parameters (first ankle rocker, value and time of maximal dorsiflexion during stance, ratio between the ankle maximal moments, peak of ankle power generation, Ankle Gait Variable Score and GPS without hip rotation) were computed, and clinical parameters (ankle passive dorsiflexion with extended and flexed knee) were extracted). Paired and Unpaired t-tests were performed to analyse differences between the two CGA for each group of treatment, between groups of treatment (only for matched patients in terms of ankle passive dorsiflexion at the first CGA) and with asymptomatic children. Sixteen ITW patients were treated surgically with a mean age at baseline of 8.6 y and a follow-up time of 2.1 y. Thirteen ITW patients were treated conservatively with mean age at baseline of 6.5 y and a follow-up time of 3.0 y. Only the surgery group had a significant improvement in ankle passive dorsiflexion. Both groups significantly improved their gait and clinical parameters. Out of the 10 patients in each treatment group who had similar ankle passive dorsiflexion at the first CGA, the surgery group showed significantly greater improvement in passive dorsiflexion and ankle power at the second CGA. In comparison to asymptomatic children, both treatment groups had significantly lower parameters. The study findings suggest that while surgical treatment for ITW resulted in improved gait outcomes, it did not result in a complete return to normal gait. Moreover, conservative treatment also resulted in improved gait outcomes. Therefore, surgical treatments should be reserved for children with severe ITW, calf muscle contracture, or complaints about pain. Further randomized controlled studies are needed with a larger sample and a longer follow-up to confirm these findings. [ABSTRACT FROM AUTHOR]