Video gait analysis for ambulatory children with cerebral palsy: Why, when, where and how!

PURPOSE: This paper outlines the application of video gait analysis (VGA) for children with cerebral palsy (CP) when full instrumented three dimensional gait analysis (3DGA) is either not indicated or not available. SCOPE: Gait analysis is an important part of the assessment of ambulant children with CP for diagnosing gait deviations and for evaluating change. Many regard 3DGA as the most informative method of assessing gait, however, it is not always accessible, practical, or feasible and the detail obtained is not always indicated. VGA in conjunction with other carefully selected outcome measures can provide a comprehensive gait assessment in situations where 3DGA is not available or not indicated. Indications for VGA use include: documenting change in gait pattern over time, frequent monitoring in the rehabilitation phase following treatments and interventions (including surgery, spasticity management, serial casting and intensive therapy), monitoring orthotic changes, and for very young children and those with behavioural/cognitive issues that preclude them from cooperating with a 3DGA. Simple and inexpensive VGA systems can be set up in most settings. In an effort to make the process more objective and reliable a number of observational gait scales have been developed. Of these the Edinburgh Gait Score (EGS) has the strongest psychometric properties and is the most comprehensive by including both the coronal and the sagittal planes. CONCLUSION: While 3DGA remains an important part of complex clinical decision-making, there is also an increasingly important role for VGA. Guidelines need to be developed for its use within the field of gait analysis.