SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference.

Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e. on its capability to change the diagnostic-therapeutic practice. In particular, the conditions in which evidence of a favorable cost-benefit ratio is found and the methodology for properly conducting and interpreting the exam are not identified clearly. To provide guidelines for the use of Gait Analysis in the context of rehabilitation medicine, SIAMOC (the Italian Society of Clinical Movement Analysis) promoted a National Consensus Conference which was held in Bologna on September 14th, 2013. The resulting recommendations were the result of a three-stage process entailing i) the preparation of working documents on specific open issues, ii) the holding of the consensus meeting, and iii) the drafting of consensus statements by an external Jury. The statements were formulated based on scientific evidence or experts' opinion, when the quality/quantity of the relevant literature was deemed insufficient. The aim of this work is to disseminate the consensus statements. These are divided into 13 questions grouped in three areas of interest: 1) General requirements and management, 2) Methodological and instrumental issues, and 3) Scientific evidence and clinical appropriateness. SIAMOC hopes that this document will contribute to improve clinical practice and help promoting further research in the field.

Repeatability of a new protocol for gait analysis in adult subjects.

The reliability of kinematic measurements has a top priority in gait analysis. The aim of the present work was to assess the inter-trial, inter-session and inter-examiner variability of an anatomical-based protocol by an established method. The gait of two young adult volunteers was analyzed by four examiners with different degrees of experience in three sessions 1 week apart. The data of five trials of level walking were collected and the rotations in the three anatomical planes of the pelvis, hip, knee and ankle were calculated. The mean value over the gait cycle of the standard deviation of these rotations was calculated for each of the 24 groups of five trials (inter-trial), the eight groups of five trials multiplied by three sessions (inter-session), and the two groups of five trials multiplied by three sessions multiplied by four examiners (inter-examiner). For each rotation, the inter-examiner variability was larger than the inter-session, and the latter larger than the inter-trial. The present ratio between inter-examiner and inter-trial variability was found to be smaller than that of the conventional protocol for each of the gait variables.