Application of the Gait Deviation Index to Study Gait Impairment in Adult Population With Spinal Cord Injury: Comparison With the Walking Index for Spinal Cord Injury Levels

Frontiers in Human Neuroscience, 2022 · DOI: 10.3389/fnhum.2022.826333 · Published: April 4, 2022

Spinal Cord Injury Neurology Biomechanics

Simple Explanation

This study investigates the applicability of the Gait Deviation Index (GDI) in individuals with Spinal Cord Injury (SCI). The GDI is a tool that measures how much someone's walking pattern differs from normal. The researchers compared GDI scores with the Walking Index for Spinal Cord Injury (WISCI) II, which measures walking ability in people with SCI. The study found that the GDI did not effectively distinguish between different levels of walking impairment as defined by the WISCI II in adults with incomplete SCI.

Study Duration

August 2019 and July 2021

Participants

34 patients with incomplete SCI and 50 healthy volunteers

Evidence Level

Not specified

Key Findings

1
The GDI was normally distributed across all WISCI II levels in both iSCI and HV groups.
2
There was an increasing relationship between GDI values and WISCI II levels in subjects with iSCI, but this was only discriminative at WISCI II levels 13, 19, and 20.
3
The GDI successfully distinguished the healthy volunteer group from individuals with iSCI.

Research Summary

This study aimed to evaluate the relationship between the Gait Deviation Index (GDI) and Walking Index for Spinal Cord Injury (WISCI) II levels in adults with incomplete spinal cord injury (iSCI). The results indicated that the GDI was not an appropriate multivariate walking metric to represent the deviation of gait pattern in adult population with iSCI when compared with WISCI II levels. Future research should focus on developing a new gait index derived from 3D kinematic gait variables specific to the SCI population and validate it against other walking ability outcome measures.

Practical Implications

Rehabilitation Strategies

The GDI may not be a suitable tool for assessing progress or tailoring interventions for individuals with iSCI based on their WISCI II level. Clinicians should consider other measures in conjunction with GDI.

Future Research

There is a need for developing a new gait index specifically for individuals with iSCI that can better capture the heterogeneity of gait patterns and correlate with other clinical measures.

Clinical Assessment

When assessing gait in adults with iSCI, relying solely on the GDI may not provide a comprehensive understanding of their walking ability as defined by WISCI II levels. Use a combination of clinical assessments.

Study Limitations

1
Reduced sample size in some WISCI II levels within the iSCI group.
2
The fact that during 3D kinematic gait analysis individuals with iSCI walked with the minimum external assistance required to walk safely.
3
Lack of registration of other walking ability outcome measures.

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