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NINDS CDE Notice of Copyright
Observational Gait Scale
Availability
Please  visit  this  website  for  access  to  Boyd  &  Graham  1999  paper  with  the instrument: Observational Gait Scale
Permission for  use   should  be  sought  from   the  authors,  Kerr   Graham,  MD, kerr.graham@rch.org.au and Roslyn Boyd, PT, PhD, r.boyd@uq.edu.au.
Classification
Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
The Observational Gait Scale (OGS) is an evaluative/observational test of gait. The main purpose of the OGS is to rate gait parameters from video recordings utilizing a structured scale. The OGS seeks to evaluate or measure the amount of change in an individuals gait pattern over time. The OGS was created as a simple low-technology tool to aid in the biomechanical assessment in the clinical setting specifically the knee joint during mid-stance (crouch and recurvatum). The target population is children and young adults with cerebral palsy aged 6–21 years.
Comments/Special Instructions
Administration time: 5–15 minutes, potentially longer with video review   Equipment: adequate space for the child to walk on a flat surface, video camera (qty. 1–2, optional but strongly recommended)
 
Examiner training: clinician with experience in gait analysis
The OGS may be particularly useful when instrumented gait analysis is not feasible, or children are too small or insufficiently cooperative for instrumented gait analysis. It can also be useful when analyzing a walk recorded by video in slow motion.
Scoring
Administration: Child either ambulates in front of camera or clinician while demonstrating most typical/natural gait pattern. An experienced clinician then scores the OGS while analyzing the gait pattern from both frontal and lateral views by checking off the correct boxes that correspond with the demonstrated gait deviation in each section of the OGS form. If the patient is videotaped then the clinician will watch video recordings to score the OGS.
 
Scoring: The OGS is a scale with 8 sections (1: Knee position in midstance, 2: Initial foot contact, 3: Foot contact at midstance, 4: Timing of heel rise, 5: Hindfoot at midstance, 6: Base of support, 7: Gait assistive devices, and 8: Change) where you score both the left and right lower extremities by selecting the appropriate numerical value. A perfect score would be a 22 on each limb. Lower scores suggest greater gait impairments.
 
Type of information, resulting from testing (e.g., standard scores, percentile ranks): The OGS gives a standard score out of 22. Overall, several items in this test are geared to quantify visually the relationship between the ankle and knee position during stance. With utilizing the OGS, Boyd & Graham (1999) looked to distinguish true equinus (plantarflexion/knee extension coupled in midstance) from apparent equinus (hamstring spasticity is greater than calf spasticity).
Rationale/Justification
Reliability: The OGS was found to have acceptable interrater and intrarater reliability for knee and foot position in mid-stance, initial foot contact, and heel rise with weighted kappas ranging from 0.53 to 0.91 (intrarater) and 0.43 to 0.86 (interrater). Comparison with 3-DGA suggests that these sections might also have high validity (range 0.38–0.94). Base of support and hind foot position had lower interrater and intrarater reliabilities (0.29 to 0.71 and 0.30 to 0.78, respectively) and were not easily validated by 3-DGA (Mackey et al, 2003.)
References
Boyd R& Graham HK. Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerebral palsy. Eur J Neurol. 1999;6(Supp. 14):S23–S35.
 
Corry IS, Cosgrove AP Duffy CM, McNeill S, Eames N, Taylor TC, Graham HK.Botulinum toxin A compared with stretching casts in the treatment of spastic equinus: a randomised prospective trial. J Paediatr Orthopaedics. 1998;18:304–311.
 
Mackey AH, Lobb GL, Walt SE, Stott NS. Reliability and validity of the Observational Gait Scale in children with spastic diplegia. Dev Med Child Neurol. 2003;45(1):4–11.
 
Koman LA, Mooney JF 3rd, Smith B, Goodman A, Mulvaney T. Management of cerebral palsy with botulinum-A toxin: preliminary investigation. J Pediatr Orthop. 1993;13(4):489–495.
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