Minimal detectable change of kinematic and spatiotemporal parameters in patients with chronic stroke across three sessions of gait analysis

Hum Mov Sci. 2019 Apr:64:101-107. doi: 10.1016/j.humov.2019.01.011. Epub 2019 Jan 31.

Abstract

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.

Keywords: Gait analysis; Minimum Detectable Change; Reproducibility; Stroke.

MeSH terms

  • Analysis of Variance
  • Ankle Joint / physiology
  • Biomechanical Phenomena / physiology
  • Chronic Disease
  • Female
  • Gait / physiology*
  • Gait Analysis / methods
  • Hip Joint / physiology
  • Humans
  • Knee Joint / physiology
  • Male
  • Middle Aged
  • Paresis / physiopathology
  • Reproducibility of Results
  • Stroke / physiopathology*