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Reliability of measurement of tempo-spatial parameters of gait after stroke using GaitMat II

The Stroke Association's Therapy Research Unit, University of Manchester, now at Centre for Rehabilitation and Ageing, St George's Hospital Medical School, University of London, UK

S H Chambers

Department of Neurological Physiotherapy, St Thomas's Hospital, London, UK

G Giakas

The Stroke Association's Therapy Research Unit, University of Manchester, now at Department of Biomechanics, University of Ioannina, Greece

M Bland

Department of Medical Statistics, St George's Hospital Medical School, University of London, UK

Objective: (1) To find the inter-rater and intra-rater reliability of raters using GaitMat II to measure tempo-spatial gait parameters of stroke patients. (2) To find if reliability is related to abnormality of footprint patterns.

Design: A prospective agreement study.

Setting: A movement analysis laboratory.

Subjects: Nineteen adults who were at least six months after stroke and able to walk 4 metres with or without assistance participated as subjects in this study. There were five raters.

Methods: Subjects completed at least two walks along GaitMat II. The raw footprint data were analysed independently by each of the five raters.

Results: Mean intraclass correlation coefficients (ICCs) for each rater within subject ranged from 0.8398 to 0.9318. However eight of the 17 parameters tested showed significant differences between raters (p = 0.0029 to p<0.0001). When the most inexperienced rater was excluded, differences between experienced raters (n = 4) was found to be statistically insignificant for all parameters. The association of the mean score and standard deviation of experienced raters was significant for nine parameters (r values 0.5087 to0.9459), i.e., as walking pattern became more abnormal, variation in scoring between raters increased.

Conclusions: GaitMat II may have acceptable inter-rater reliability if raters have experience of gait analysis but disagreement may increase when stroke patients exhibit more abnormal gait patterns.

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