Changes in gait, balance, and function with vestibular rehabilitation

Susan P. Barker

doi:10.17918/etd-300

One of the most common functional deficits encountered by physical therapy clinicians is gait dysfunction. If physical therapists are to make evidence-based decisions in the clinical management of patients with gait dysfunction, they need the ability to measure spatiotemporal gait variables validly and reliably. A gait analysis system that is relatively inexpensive and portable is the GaitMat II (GM). Several studies were undertaken to examine reliability and validity of the GM. Three different GM systems were compared with regard to placement of their switches. Although variability was present, error analysis demonstrated that the variability in switch placements was much less than the normal variability of most gait variables measured with the GM. Another study compared the accuracy and reliability of measures taken with the GM system with the same measures taken simultaneously with the Vicon motion analysis system. Results indicated excellent agreement between the GM and Vicon systems for timing variables but poor agreement between the measures for distance variables. The mean difference between the measures for distance variables was 11.7 mm, an error amount that would have little clinical significance in adults for distance measures such as step length or stride length. Another study examined the validity of gait measures collected with the GM from patients with a diagnosis of unilateral vestibular hypofunction (UVH) before and after they participated in vestibular rehabilitation and compared these values with those collected from a matched group of subjects without vestibular pathology. The change in gait variables after vestibular rehabilitation was compared with the change in Dizziness Handicap Inventory scores and computerized posturography composite scores. No significant difference was found following vestibular rehabilitation in any gait variable in this sample. In this sample, gait variables measured with the GM were not affected by vestibular rehabilitation in the same manner as other clinical measures. A discriminant analysis demonstrated that gait data collected with the GaitMat II can classify subjects without vestibular pathology with 100% accuracy and subjects with UVH with 90.9% accuracy. In summary, the results of these studies support the reliability and validity of the GaitMat II as a clinical gait analysis tool.

Changes in gait, balance, and function with vestibular rehabilitation

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Changes in gait, balance, and function with vestibular rehabilitation

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