Inter-observer agreement and distal pedobarographic asymmetry patterns in trauma-related antalgic and Trendelenburg gait: A pilot study

Makaleler > Tam Makale · 2026

Yazarlar: Merve Çakal, Ekin Özgür AKTAŞ, Dilek BAYRAKTAR, Anıl Murat ÖZTÜRK, Ahsen KAYA

JOURNAL OF BIOMECHANICS, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Scopus, 2026, cilt 205, ss 113432-113432

DOI: 10.1016/j.jbiomech.2026.113432

Özet

<p><span style="color: rgb(31, 31, 31);">Observational&nbsp;gait&nbsp;assessment&nbsp;is&nbsp;commonly&nbsp;used&nbsp;in&nbsp;clinical&nbsp;and&nbsp;medicolegal&nbsp;practice,&nbsp;although&nbsp;the&nbsp;reliability&nbsp;in&nbsp;differentiating&nbsp;antalgic&nbsp;and&nbsp;Trendelenburg&nbsp;gait&nbsp;patterns&nbsp;is&nbsp;questionable.&nbsp;This&nbsp;prospective&nbsp;pilot&nbsp;study&nbsp;examined&nbsp;the&nbsp;interobserver&nbsp;agreement&nbsp;in&nbsp;observational&nbsp;gait&nbsp;classification&nbsp;and&nbsp;explored&nbsp;associations&nbsp;between&nbsp;observational&nbsp;gait&nbsp;patterns&nbsp;and&nbsp;distal&nbsp;pedobarographic&nbsp;asymmetry&nbsp;parameters&nbsp;in&nbsp;a&nbsp;trauma-related&nbsp;patient&nbsp;sample.</span></p><p><span style="color: rgb(31, 31, 31);">Adult&nbsp;participants&nbsp;with&nbsp;lower-extremity&nbsp;trauma&nbsp;were&nbsp;prospectively&nbsp;enrolled&nbsp;(n&nbsp;=&nbsp;31).&nbsp;Two&nbsp;observers&nbsp;independently&nbsp;performed&nbsp;blinded&nbsp;observational&nbsp;gait&nbsp;assessments.&nbsp;Pedobarographic&nbsp;measurements&nbsp;were&nbsp;obtained&nbsp;using&nbsp;a&nbsp;standardized&nbsp;protocol,&nbsp;and&nbsp;asymmetry&nbsp;parameters&nbsp;were&nbsp;analyzed&nbsp;by&nbsp;a&nbsp;physiotherapist&nbsp;blinded&nbsp;to&nbsp;observational&nbsp;classifications.&nbsp;Cohen’s&nbsp;κ&nbsp;was&nbsp;used&nbsp;to&nbsp;assess&nbsp;inter-observer&nbsp;agreement&nbsp;between&nbsp;the&nbsp;two&nbsp;clinical&nbsp;observers.&nbsp;Pedobarographic&nbsp;measurements&nbsp;were&nbsp;analyzed&nbsp;independently,&nbsp;and&nbsp;exploratory&nbsp;analyses&nbsp;examined&nbsp;associations&nbsp;between&nbsp;inter-limb&nbsp;asymmetry&nbsp;parameters&nbsp;and&nbsp;observational&nbsp;gait&nbsp;classifications.</span></p><p><span style="color: rgb(31, 31, 31);">Inter-observer&nbsp;agreement&nbsp;for&nbsp;antalgic&nbsp;gait&nbsp;was&nbsp;low&nbsp;(κ&nbsp;=&nbsp;0.10;&nbsp;95&nbsp;%&nbsp;CI&nbsp;−&nbsp;0.20&nbsp;to&nbsp;0.43),&nbsp;whereas&nbsp;agreement&nbsp;for&nbsp;Trendelenburg&nbsp;gait&nbsp;ranged&nbsp;from&nbsp;fair&nbsp;to&nbsp;moderate.&nbsp;Inter-limb&nbsp;asymmetry&nbsp;in&nbsp;forefoot&nbsp;push-off&nbsp;phase&nbsp;duration&nbsp;showed&nbsp;the&nbsp;strongest&nbsp;exploratory&nbsp;association&nbsp;with&nbsp;observational&nbsp;gait&nbsp;classification&nbsp;(</span><em style="color: rgb(31, 31, 31);">p</em><span style="color: rgb(31, 31, 31);">&nbsp;&lt;&nbsp;0.001;&nbsp;Cliff’s&nbsp;δ&nbsp;=&nbsp;&nbsp;−&nbsp;0.89).</span></p><p><span style="color: rgb(31, 31, 31);">In&nbsp;this&nbsp;trauma-related&nbsp;pilot&nbsp;sample,&nbsp;observational&nbsp;classification&nbsp;of&nbsp;antalgic&nbsp;and&nbsp;Trendelenburg&nbsp;gait&nbsp;demonstrated&nbsp;limited&nbsp;inter-observer&nbsp;agreement.&nbsp;Distal&nbsp;pedobarographic&nbsp;asymmetry&nbsp;patterns&nbsp;may&nbsp;be&nbsp;associated&nbsp;with&nbsp;observational&nbsp;gait&nbsp;categories;&nbsp;however,&nbsp;in&nbsp;the&nbsp;absence&nbsp;of&nbsp;an&nbsp;independent&nbsp;kinematic&nbsp;reference&nbsp;standard,&nbsp;these&nbsp;results&nbsp;should&nbsp;be&nbsp;interpreted&nbsp;as&nbsp;hypothesis-generating.</span></p><p></p>

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