Are clinical measurements linked to the Gait Deviation Index in cerebral palsy patients?

ObjectiveFrom a dataset of clinical assessments and gait analysis, this study was designed to determine which of the assessments or their combinations would most influence a low gait index (i.e., severe gait deviations) for individuals with cerebral palsy.DesignA retrospective search, including clinical and gait assessments, was conducted from August 2005 to September 2009.PopulationOne hundred and fifty-five individuals with a clinical diagnosis of cerebral palsy (CP) (mean age (SD): 11 (5.3) years) were selected for the study.MethodQuinlan's Interactive Dichotomizer 3 algorithm for decision-tree induction, adapted to fuzzy data coding, was employed to predict a Gait Deviation Index (GDI) from a dataset of clinical assessments (i.e., range of motion, muscle strength, and level of spasticity).ResultsSeven rules that could explain severe gait deviation (a fuzzy GDI low class) were induced. Overall, the fuzzy decision-tree method was highly accurate and permitted us to correctly classify GDI classes 9 out of 10 times using our clinical assessments.ConclusionThere is an important relationship between clinical parameters and gait analysis. We have identified the main clinical parameters and combinations of these parameters that lead to severe gait deviations. The strength of the hip extensor, the level of spasticity and the strength of the tibialis posterior were the most important clinical parameters for predicting a severe gait deviation.

► Fuzzy decision tree is a useful technique to model gait deviations. ► There is an important relationship between clinical parameters and gait deviations. ► The strength of the hip extensor is a good predictor of severe gait deviation.