Inter-session agreement and reliability of the Global Gait Asymmetry index in healthy adults

There has been a growing effort in restoring gait symmetry in clinical conditions associated with pronounced gait asymmetry. A prerequisite to achieve this is that the chosen approach can accurately assess symmetry and detect/impose changes that exceed the natural day to day variability. Global symmetry indices are superior to local and discrete indices because they capture the patient's overall gait symmetry. However, their repeatability is unknown. This study assessed the inter-session agreement and reliability of the Global Gait Asymmetry index. Twenty-three healthy individuals participated in two 3D gait analyses, performed approximately one week apart. The 95% limits of agreement, standard error of measurement, smallest detectable change, and intraclass correlation coefficient were analysed. The obtained values showed this index has poor agreement and reliability between sessions. Therefore, it cannot be used to assess the patient's progress overtime nor to compare symmetry levels among groups. (C) 2016 Elsevier B.V. All rights reserved.