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Background: Three-dimensional motion analysis using optoelectronic cameras and force platforms is typically used to quantify gait disorders. However, these systems have various limitations, particularly when assessing patients in an ecological environment. To address these limitations, several wearable devices have been developed. However, few studies have reported metrological information regarding their repeatability and sensitivity to change., Methods: A healthy adult performed 6 min walking tests with FeetMe ® system insoles under different walking conditions overground and on a treadmill. The standard error of measurement (SEM), the minimum detectable differences (MDDs), and the effect size (ES) were calculated for spatio-temporal parameters, and the ground reaction force was calculated from the 16,000 steps recorded., Results: SEM values were below 3.9% for the ground reaction force and below 6.8% for spatio-temporal parameters. ES values were predominantly high, with 72.9% of cases between overground and treadmill conditions with induced asymmetry, and 64.5% of cases between treadmill conditions with and without induced asymmetry exhibiting an ES greater than 1.2. The minimum detectable differences ranged from 4.5% to 10.7% for ground reaction forces and 2.1% to 18.9% for spatio-temporal parameters., Conclusion: Our study demonstrated that the FeetMe ® system is a reliable solution. The sensitivity to change showed that these instrumented insoles can effectively reflect patient asymmetry and progress.

Three-dimensional gait analysis is the gold standard for gait-assessment in patients with stroke. This technique is commonly used to assess the effect of treatment on gait parameters. In clinical practice, three gait analyses are usually carried out (baseline, after treatment and follow-up), the objectives were to define the reproducibility and the Minimum Detectable Change (MDC) for gait parameters in stance and swing measured using 3D-gait analysis, and to assess changes in MDC across three repeated 3D-gait analyses. Three gait analyses (V1, V2 and V3) were performed at 7-day intervals in twenty-six patients with chronic stroke. Kinematic data (in the sagittal plane, during swing and stance) and spatiotemporal data were evaluated for the paretic limb. Reliability was tested using repeated measures ANOVA with a Tukey post hoc test, and the MDC values were calculated for each parameter. Only the range of hip motion during swing changed significantly between V1 and V2, but no other kinematic parameters changed. No significant differences were observed for the spatiotemporal parameters. MDC values were always higher during the V1vsV2 comparison for both kinematic and spatiotemporal parameters. This is the first study to evaluate the MDC for kinematic and spatiotemporal parameters during stance and swing. Reliability of kinematic and spatiotemporal data across sessions was very good over the three sessions. MDC values were the lowest between V2 and V3 for most parameters. Use of the MDC will allow clinicians to more accurately determine the effect of treatments., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Medial tibiofemoral joint contact forces can be estimated using musculoskeletal models. To assess change in these forces that accompany load-modifying interventions, minimum detectable change (MDC) thresholds must be established. The primary study purpose was to derive MDCs for medial tibiofemoral peak force and force impulse during walking. The secondary purpose was to identify the proportions of individuals exhibiting reductions greater than these MDCs when walking with lateral foot wedging. Eight healthy individuals provided 3-dimensional gait data over 3 test sessions to serve as inputs for an inverse dynamics-driven medial tibiofemoral contact force model, from which MDCs for peak force and impulse were derived. The MDC was 0.246 BW (8.7%) for peak force and 0.0385 BW∙s (3.7%) for impulse. Then, 25 healthy individuals provided gait data by walking with and without 6° laterally wedged foot orthoses, and the proportion of individuals exhibiting changes in medial tibiofemoral contact peak force and impulse values exceeding the MDC threshold was determined. For impulse and peak force, 52% and 4% of participants exhibited a decrease exceeding the MDC, respectively. In summary, medial tibiofemoral contact force MDCs were derived, with impulse showing greater sensitivity than peak force to the effects of a biomechanical intervention.

The Gait Deviation Index (GDI) is a summary measure that provides a global picture of gait kinematic data. Since the ability to walk is critical for post-stroke patients, the aim of this study was to determine the reliability and Minimum Detectable Change (MDC) of the GDI in this patient population. Twenty post-stroke patients (11 males, 9 females; mean age, 55.2±9.9years) participated in this study. Patients presented with either right- (n=14) or left-sided (n=6) hemiparesis. Kinematic gait data were collected in two sessions (test and retest) that were 2 to 7days apart. GDI values in the first and second sessions were, respectively, 59.0±8.1 and 60.2±9.4 for the paretic limb and 53.3±8.3 and 53.4±8.3 for the non-paretic limb. The reliability in each session was determined by the intra-class correlation coefficient (ICC) of three strides and, in the test session, their values were 0.91 and 0.97 for the paretic and non-paretic limbs, respectively. Between-session reliability and MDC were determined using the average GDI of three strides from each session. For the paretic limb, between-session ICC, standard error of measurement (SEM), and MDC were 0.84, 3.4 and 9.4, respectively. Non paretic lower limb exhibited between-session ICC, standard error of measurement (SEM), and MDC of 0.89, 2.7 and 7.5, respectively. These MDC values indicate that very large changes in GDI are required to identify gait improvement. Therefore, the clinical usefulness of GDI with stroke patients is questionable., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The objectives of this work were (i) to determine Gait Profile Score (GPS) for hemiparetic stroke patients, (ii) to evaluate its reliability within and between sessions, and (iii) to establish its minimal detectable change (MDC). Seventeen hemiparetic patients (mean age 54.9±10.5years; 9 men and 8 women; 6 hemiparetic on the left side and 11 on the right side; mean time after stroke 6.1±3.5months) participated in 2 gait assessment sessions within an interval of 2-7 days. Intra-session reliability was obtained from the intraclass correlation coefficient (ICC) between the three strides of each session. Inter-session reliability was estimated by the ICC from the averages of that three strides. GPS value of non paretic lower limb (NPLL) (13.9±2.4°) was greater than that of paretic lower limb (PLL) (12.0±2.8°) and overall GPS (GPS_O) was 13.7±2.5°. The Gait Variable Scores (GVS), GPS and GPS_O exhibited intra-session ICC values between 0.70 and 0.99, suggesting high intra-day stability. Most of GVS exhibited excellent inter-session reliability (ICC between 0.81 and 0.93). Only hip rotation, hip abduction of PLL exhibited moderate reliability with ICC/MDC values of 0.57/10.0° and 0.71/3.1°, respectively. ICC/MDC values of GPS were 0.92/2.3° and 0.93/1.9° for PLL and NPLL, respectively. GPS_O exhibited excellent test-retest reliability (ICC=0.95) and MDC of 1.7°. Given its reliability, the GPS has proven to be a suitable tool for therapeutic assessment of hemiparetic patients after stroke., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Reduced stepping speed is associated with balance deficits and falls in older adults. We evaluated psychometric properties of a test of rapid stepping, the Thirty-Rapid-Step test (30-RST) in 37 community-dwelling older adults. Participants performed the 30-RST, dynamic (step execution time, five-times-sit-to-stand test, gait speed, maximum step length and four-square-step test) and static (single-leg-stance-time and postural sway) performance-based tests. Relationships between 30-RST and performance-based tests were evaluated with Spearman's rho. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), 95% limits of agreement and minimum detectable change at the 95% confidence level (MDC95) were computed for the 30-RST. Relationships between 30-RST and dynamic measures were moderate to very good (r = -0.35-0.73, p < 0.05); however, relationships between 30-RST and static balance were weak (r = 0.04-0.19, p > 0.05). The ICC2,1 was 0.85 for 30-RST indicating excellent test-retest reliability. SEM expressed as a percent of mean 30-RST was 8.2%, indicating low measurement error. The MDC95 was 9.4 s, and MDC95 expressed as a percent of mean 30-RST was moderately low at 22.6%. The 30-RST is a valid measure of dynamic balance and mobility with excellent relative and absolute reliability, and may be a useful measure in geriatric clinical settings and studies investigating balance in healthy community-dwelling older adults.

This article describes a conglomerate measure of gait variability based on nine spatiotemporal parameters: the Gait Variability Index (GVI). Concurrent validity, inter-session reliability and minimum detectable change (MDC) were evaluated in 31 patients with Friedreich's Ataxia (FRDA), through comparisons with classically used evaluation tools such as the International Cooperative Ataxia Rating Scale (ICARS). GVI scores for the healthy population were 100.3±8.6 and were significantly reduced in FRDA patients (70.4±7.9). The GVI was correlated with the global ICARS score and was sensitive enough to differentiate between groups of FRDA patients categorized by the Posture and Gait Disturbances sub-score. The GVI was found to have a high inter-session reliability with an intraclass correlation coefficient of 0.91. A MDC of 8.6 points was found necessary to ensure that a change in GVI reflects a true change rather than measurement error. The GVI provides a quantitative measure of variability which behaves well statistically in both HP and patients with FRDA. It can be easily implemented using the supplemental data provided with this article. Complementary work is necessary to strengthen the GVI validation., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The reliability of tests to be used in research or clinical practice should be established for each population specific to their intended use. Reliability is important because it allows correct evaluations to be made about treatment effects or about the amount of changes. To evaluate the test-retest reliability and minimal detectable change of the L-test in patients with advanced knee osteoarthritis (OA). The intraclass correlation coefficient (ICC2,1) was used to assess the test-retest reliability of the L-test. The minimal detectable change with 95% confidence interval (MDC95) was calculated to determine the true change. The inclusion criteria were diagnosis of knee OA, had Kellgren Lawrence Grade IV and age of ≥40 years. Twenty-five participants who met the inclusion criteria were included. Five were male and the mean age was 62.32±9.77 years. All of the participants had radiographic findings indicative of Kellgren-Lawrence Grade IV. The L-test showed excellent test-retest reliability. The ICC was 0.99, the SEM and the MDC95 was 1,90 and 5.28 seconds, respectively. The L-test is a reliable outcome measurement for the assessment of walking ability in patients with advanced knee OA, and it showed very high test-retest reliability in these patients. This test may assist clinicians and researchers in assessing the functional mobility of patients and planning rehabilitation in patients with advanced knee OA. [ABSTRACT FROM AUTHOR]

Background: Gait limitation is one of the most common disabilities in people with multiple sclerosis (MS). Several studies have used gait parameters to determine the effects of different therapies. However, few studies have determined their reproducibility, also the therapeutic effects could be overestimated.Research Question: To examine the reproducibility in gait measurements during short and long distances.Methods: In this cross-sectional study we recruited a group of MS patients and compare it to a control group. The participants performed the following tests in a fixed order: a 25-foot walk at a comfortable speed, at a fast speed and during a dual task, a timed up-and-go test (TUG) and a six- minute walk test (6MWT). Two measurements were conducted a week apart. Systematic error was evaluated by the Student t-test, reliability by the intra-class correlation coefficients (ICC) and agreement by the minimum detectable change (MDC95).Results: A total of 58 people with MS and 19 healthy people were included. The absence of systematic error was only found for the fast speed condition. The reliability of the gait parameters had moderate to high ICC values (ICC > 0.7) except for the dual task cost (DTC) which was 0.45. The MDC95 was higher in people with MS compared to healthy people, and it was higher in people with MS for gait speeds in all conditions (> 34%). For the TUG and 6MWT, the MDC95 were 51.5% and 31.7% respectively. For people with MS the smallest MDC95 was found for the stance time for all conditions (6.8%), whereas the highest was found for the dual task cost (158.7%).Significance: The MDC95 values were higher than the cut-off point based on the minimally important clinical difference (MICD) proposed in previous studies. Thus, the MDC95 should be used as a cut-off rather than MICD values. [ABSTRACT FROM AUTHOR]

Objective Fatigue and gait impairment are two of the most common and disabling symptoms in patients with multiple sclerosis (PwMS). If on one side, the gait evaluation of PwMS is well established, on the other side, there is no consensus about which instrument is the most pertinent and reproducible to evaluate fatigue in PwMS [1] . The objectives of this study were: – to determine which fatigue scales is the most reproducible and; – to establish the associations between fatigue scales and the gait of PwMS. Materials/patients and methods 59 PwMS with an EDSS score between 4 and 7 participated in this study. The fatigue was assessed with 2 main specific scales for PwMS: FSS and EMIF-SEP (separated in four subscales [physical, cognitive, social and psychological]). The gait was evaluated at a fast condition as described in previous study [2] . Two identical measures were conducted at one-week interval without therapeutic intervention. For the reproducibility evaluations a student t -test (for systematic error), intra-class correlation coefficients (ICC) and minimum detectable change (MDC95) were calculated. Finally, to evaluate the contribution of fatigue to PwMS’ gait velocity, a multi-linear regression model (stepwise-forward) was used. Results No systematic error was found for both fatigue scales. EMIF-SEP (ICC > 0.76) showed a better reliability than FSS (ICC = 0.69). In terms of agreement, the MDC95 score of the EMIF-SEP (MDC95: 17.86–22.09 point of percentage) was less than those founded for FSS (33.33 point of percentage). No correlation was found between fatigue scales including the EMIF-SEP subscales and the gait velocity. Discussion/Conclusion The EMIF-SEP and its subscales had better reproducibility scores than the FSS, suggesting that it is most adapted to test the effect of therapeutic interventions in PwMS’ fatigue. The fatigue assessed with questionnaires seems not to be associated with gait impairment. This result suggested that an independent approach should be taken into account to relief these two main symptoms of MS. [ABSTRACT FROM AUTHOR]