Studies have shown good reliability for gait analysis interpretation among surgeons from the same institution. However, reliability among surgeons from different institutions remains to be determined. Is gait analysis interpretation by surgeons from different institutions as reliable as it is for surgeons from the same institution? Gait analysis data for 67 patients with cerebral palsy (CP) were reviewed prospectively by two orthopedic surgeons from different institutions in the same state, each with > 10 years’ experience interpreting gait analysis data. The surgeons identified gait problems and made treatment recommendations for each patient using a rating form. Percent agreement between raters was calculated for each problem and treatment, and compared to expected agreement based on chance using Cohen’s kappa. For problem identification, the greatest agreement was seen for equinus (85% agreement), calcaneus (88%), in-toeing (89%), and out-toeing (90%). Agreement for the remaining problems ranged between 66–78%. Percent agreement was significantly higher than expected due to chance for all issues (p ≤ 0.01) with modest kappa values ranging from 0.12 to 0.51. Agreement between surgeons for treatment recommendations was highest for triceps surae lengthening (89% agreement), tibial derotation osteotomy (90%), and foot osteotomy (87%). Agreement for the remaining treatments ranged between 72–78%. Percent agreement for all treatments was significantly higher than the expected values (p ≤ 0.002) with modest kappa values ranging from 0.22 to 0.52. Previous research established that computerized gait analysis data interpretation is reliable for surgeons within a single institution. The current study demonstrates that gait analysis interpretation can also be reliable among surgeons from different institutions. Future research should examine reliability among physicians from more institutions to confirm these results.

中文翻译：

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脑瘫步态分析解释可靠性的最新进展：机构间协议

研究表明，来自同一机构的外科医生的步态分析解释具有良好的可靠性。然而，来自不同机构的外科医生的可靠性仍有待确定。来自不同机构的外科医生的步态分析解释与来自同一机构的外科医生的步态分析解释一样可靠吗？来自同一州不同机构的两名骨科医生对 67 名脑瘫 (CP) 患者的步态分析数据进行了前瞻性审查，每位骨科医生都拥有超过 10 年解释步态分析数据的经验。外科医生确定了步态问题，并使用评级表为每位患者提出了治疗建议。针对每个问题和处理计算评估者之间的一致性百分比，并使用 Cohen 的 kappa 与基于机会的预期一致性进行比较。对于问题识别，马蹄足（85% 一致）、跟骨（88%）、内八字（89%）和外八字（90%）的一致性最高。对其余问题的同意率在 66-78% 之间。由于所有问题 (p ≤ 0.01) 的 kappa 值范围在 0.12 到 0.51 之间，因此一致性百分比显着高于预期。外科医生之间对小腿三头肌延长术、胫骨去旋转截骨术（90%）和足截骨术（87%）的治疗建议的一致性最高。其余治疗的一致性在 72-78% 之间。所有处理的一致性百分比显着高于预期值 (p ≤ 0.002)，kappa 值范围为 0.22 至 0.52。先前的研究表明，计算机步态分析数据解释对于单个机构内的外科医生来说是可靠的。目前的研究表明，步态分析解释对于来自不同机构的外科医生来说也是可靠的。未来的研究应该检查来自更多机构的医生的可靠性，以证实这些结果。