THE QUALITY ASSESSMENT OF WALKING IN CEREBRAL-PALSY

The primary aim of intervention in cerebral palsy is to improve the qu ality of walking. However, we have no means of measuring this quality or its change following treatment. In this study we set out to develop a quality score for walking which can objectively quantify quality an d its change following intervention. We video recorded 60 children whi le walking, 55 with spastic diplegia and 5 normal children and asked 8 observers to grade the quality of their walking ability using an anal ogue scale. Having demonstrated the reliability of the scale, each chi ld's quality score was then compared with their sagittal plane kinemat ic data and their functional data. Balance, speed, range of motion and effort emerged as the key objective and measurable features which det ermine the quality of walking. These four features were weighted in a formula to equate with the quality scores. The formula was tested usin g the final 20 patients by comparing their predicted quality scores as derived from the formula with the actual quality scores as determined by the observers. Copyright (C) 1997 Elsevier Science B.V.