{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:43:04Z","timestamp":1762868584995,"version":"build-2065373602"},"reference-count":57,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/00447\/2020"],"award-info":[{"award-number":["UIDB\/00447\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Applied Sciences"],"abstract":"<jats:p>Background: Cerebral palsy (CP) is a complex pathology that describes a group of motor disorders with different presentations and functional levels. Three-dimensional gait analysis is widely used in the assessment of CP children to assist in clinical decision making. Thus, it is crucial to assess the repeatability of gait measurements to evaluate the progress of the rehabilitation process. The purpose of the study is to evaluate test-retest reliability of a six-degree-of-freedom (6DoF) marker set in key points of gait kinematics, kinetics, and time-distance parameters in children with CP. Methods: trials were performed on two different days within a period of 7.5 \u00b1 1.4 day. Motion capture data was collected with 14 infrared, high-speed cameras at a frequency rate of 100 Hz, synchronized in time and space with two force plates. Intraclass correlation coefficients considering the two-way mixed model, and absolute agreement (ICC[A,k]) were calculated for anthropometric, time\u2013distance, kinematic and kinetic parameters of both lower limbs. Results: the majority of gait parameters demonstrated a good ICC, and the lowest values were in the kinematic variables. Conclusions: this study indicates wide-ranging reliability values for lower limb joint angles and joint moments of force during gait, especially for frontal and transverse planes. Although the use of a 6DoF-CAST in CP children was shown to be a feasible method, the gait variation that can be observed between sessions in CP children seems to be related not only to the extrinsic factors but also to their different gait patterns and affected sides.<\/jats:p>","DOI":"10.3390\/app11146515","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T09:32:07Z","timestamp":1626341527000},"page":"6515","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Test-Retest Reliability of a 6DoF Marker Set for Gait Analysis in Cerebral Palsy Children"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6990-8813","authenticated-orcid":false,"given":"Diogo","family":"Ricardo","sequence":"first","affiliation":[{"name":"CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada-Dafundo, 1499-002 Oeiras, Portugal"},{"name":"Escola Superior de Tecnologia da Sa\u00fade de Lisboa (ESTeSL), Instituto Polit\u00e9cnico de Lisboa, Av. D. Jo\u00e3o II, 1990-096 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5923-6582","authenticated-orcid":false,"given":"J\u00falia","family":"Teles","sequence":"additional","affiliation":[{"name":"CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada-Dafundo, 1499-002 Oeiras, Portugal"}]},{"given":"Maria Raquel","family":"Raposo","sequence":"additional","affiliation":[{"name":"CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada-Dafundo, 1499-002 Oeiras, Portugal"}]},{"given":"Ant\u00f3nio Prieto","family":"Veloso","sequence":"additional","affiliation":[{"name":"CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada-Dafundo, 1499-002 Oeiras, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-0932","authenticated-orcid":false,"given":"Filipa","family":"Jo\u00e3o","sequence":"additional","affiliation":[{"name":"CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada-Dafundo, 1499-002 Oeiras, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"ref_1","unstructured":"Dan, B., Mayston, M., Paneth, N., and Rosenbloom, L. (2014). Definition and Clinical Classification. Cerebral Palsy: Science and Clinical Practice, Mac Keith Press. [1st ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15082","DOI":"10.1038\/nrdp.2015.82","article-title":"Cerebral palsy","volume":"2","author":"Graham","year":"2016","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.paed.2016.04.011","article-title":"Aetiology and epidemiology of cerebral palsy","volume":"26","author":"Eunson","year":"2016","journal-title":"Paediatr. Child Health"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"(2000). Surveillance of cerebral palsy in Europe: A collaboration of cerebral palsy surveys and registers. Dev. Med. Child Neurol., 42, 816\u2013824.","DOI":"10.1111\/j.1469-8749.2000.tb00695.x"},{"key":"ref_5","unstructured":"(2018). Cerebral Palsy. Cerebral Palsy, Springer."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/S0140-6736(13)61835-8","article-title":"Cerebral palsy","volume":"383","author":"Colver","year":"2014","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.annepidem.2016.01.001","article-title":"Prevalence of cerebral palsy and intellectual disability among children identified in two U.S. National Surveys, 2011\u20132013","volume":"26","author":"Maenner","year":"2016","journal-title":"Ann. Epidemiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1177\/107110078300400304","article-title":"Pathodynamics of Gait Alterations in Cerebral Palsy and the Significance of Kinetic Electromyography in Evaluating Foot and Ankle Problems","volume":"4","author":"Hoffer","year":"1983","journal-title":"Foot Ankle"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1469-8749.2007.00201.x","article-title":"The Definition and Classification of Cerebral Palsy","volume":"49","author":"Rosenbaum","year":"2007","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.pmr.2019.09.007","article-title":"Principles of Ankle-Foot Orthosis Prescription in Ambulatory Bilateral Cerebral Palsy","volume":"31","author":"Wright","year":"2020","journal-title":"Phys. Med. Rehabil. Clin. N. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.gaitpost.2008.09.003","article-title":"The reliability of three-dimensional kinematic gait measurements: A systematic review","volume":"29","author":"McGinley","year":"2009","journal-title":"Gait Posture"},{"key":"ref_12","unstructured":"Altman, D. (2020). Practical Statistics for Medical Research, Chapman & Hall\/CRC. [2nd ed.]."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Molina-Rueda, F., Fern\u00e1ndez-Gonz\u00e1lez, P., Cuesta-G\u00f3mez, A., Koutsou, A., Carratal\u00e1-Tejada, M., and Miangolarra-Page, J. (2021). Test-Retest Reliability of a Conventional Gait Model for Registering Joint Angles during Initial Contact and Toe-Off in Healthy Subjects. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18031343"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.gaitpost.2017.02.028","article-title":"Within-assessor reliability and minimal detectable change of gait kinematics in a young obese demographic","volume":"54","author":"Horsak","year":"2017","journal-title":"Gait Posture"},{"key":"ref_15","unstructured":"M\u00fcller, B., and Wolf, S. (2018). Variations of marker sets and models for standard gait analysis. Handbook of Human Motion, Springer AG. [1st ed.]."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1002\/jor.1100070611","article-title":"Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait","volume":"7","author":"Kadaba","year":"1989","journal-title":"J. Orthop. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.gaitpost.2007.11.009","article-title":"Quantitative comparison of five current protocols in gait analysis","volume":"28","author":"Ferrari","year":"2008","journal-title":"Gait Posture"},{"key":"ref_18","unstructured":"M\u00fcller, B., and Wolf, S. (2018). The Conventional Gait Model\u2014Success and Limitations. Handbook of Human Motion, Springer AG. [1st ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.gaitpost.2009.04.004","article-title":"A six degrees-of-freedom marker set for gait analysis: Repeatability and comparison with a modified Helen Hayes set","volume":"30","author":"Collins","year":"2009","journal-title":"Gait Posture"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.medengphy.2019.11.002","article-title":"Reliability and measurement error of multi-segment trunk kinematics and kinetics during cerebral palsy gait","volume":"75","author":"Kiernan","year":"2020","journal-title":"Med. Eng. Phys."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.gaitpost.2015.08.002","article-title":"Test\u2013retest reliability and minimal detectable change of three-dimensional gait analysis in chronic low back pain patients","volume":"42","author":"Fernandes","year":"2015","journal-title":"Gait Posture"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3131","DOI":"10.1109\/TBME.2013.2268938","article-title":"Soft Tissue Artifact Assessment during Treadmill Walking in Subjects with Total Knee Arthroplasty","volume":"60","author":"Thiran","year":"2013","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S0268-0033(99)00057-1","article-title":"Intrasubject repeatability of gait analysis data in normal and spastic children","volume":"15","author":"Steinwender","year":"2000","journal-title":"Clin. Biomech."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/0966-6362(96)80579-0","article-title":"Reliablity of kinematics during clinical gait analysis: A comparison between normal and children with cerebal palsy","volume":"4","author":"Miller","year":"1996","journal-title":"Gait Posture"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/01241398-200305000-00001","article-title":"Interobserver Variability of Gait Analysis in Patients with Cerebral Palsy","volume":"23","author":"Noonan","year":"2003","journal-title":"J. Pediatr. Orthop."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gaitpost.2004.06.002","article-title":"Reliability of upper and lower limb three-dimensional kinematics in children with hemiplegia","volume":"22","author":"Mackey","year":"2005","journal-title":"Gait Posture"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1016\/j.jbiomech.2012.05.014","article-title":"Evaluating the properties of the coefficient of multiple correlation (CMC) for kinematic gait data","volume":"45","author":"Skare","year":"2012","journal-title":"J. Biomech."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/j.1469-8749.1997.tb07414.x","article-title":"Development and reliability of a system to classify gross motor function in children with cerebral palsy","volume":"39","author":"Palisano","year":"1997","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_29","unstructured":"Gibson, J. (1986). Gibson Theory of Affordances, Lawrence Erlbaum Associates, Inc.. [1st ed.]."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.gaitpost.2004.04.004","article-title":"Human movement analysis using stereophotogrammetry: Part 2: Instrumental errors","volume":"21","author":"Chiari","year":"2005","journal-title":"Gait Posture"},{"key":"ref_31","first-page":"446","article-title":"Sensitivity of Joint Kinematics and Kinetics to Different Pose Estimation Algorithms and Joint Constraints in the Elderly","volume":"30","author":"Cabral","year":"2013","journal-title":"J. Appl. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/S0966-6362(01)00125-4","article-title":"The reliability of kinetic and kinematic variables used to analyse normal running gait","volume":"14","author":"Diss","year":"2001","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.gaitpost.2016.08.013","article-title":"Orthotic correction of lower limb function during gait does not immediately influence spinal kinematics in spastic hemiplegic cerebral palsy","volume":"49","author":"Schmid","year":"2016","journal-title":"Gait Posture"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.gaitpost.2006.04.011","article-title":"Increasing the number of gait trial recordings maximises intra-rater reliability of the CODA motion analysis system","volume":"25","author":"Monaghan","year":"2007","journal-title":"Gait Posture"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.gaitpost.2016.07.075","article-title":"Reliability of 3D gait data across multiple laboratories","volume":"49","author":"Kaufman","year":"2016","journal-title":"Gait Posture"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/0268-0033(95)91394-T","article-title":"Position and orientation in space of bones during movement: Anatomical frame definition and determination","volume":"10","author":"Cappozzo","year":"1995","journal-title":"Clin. Biomech."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/0021-9290(90)90054-7","article-title":"A comparison of the accuracy of several hip center location prediction methods","volume":"23","author":"Bell","year":"1990","journal-title":"J. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/0020-7101(96)01167-1","article-title":"Optimization and smoothing techniques in movement analysis","volume":"41","author":"Cappello","year":"1996","journal-title":"Int. J. Biomed. Comput."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Dempster, W.T. (1955). Space Requirements of the Seated Operator, Geometrical, Kinematic, and Mechanical Aspects of the Body with Special Reference to the Limbs, Wright-Patterson Air Force Base.","DOI":"10.21236\/AD0087892"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Hanavan, E.P. (1964). A Mathematical Model of the Human Body.","DOI":"10.1037\/e400822004-001"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/S0021-9290(01)00222-6","article-title":"ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion\u2014Part I: Ankle, hip, and spine","volume":"35","author":"Wu","year":"2002","journal-title":"J. Biomech."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Robertson, D.G.E., Caldwell, G.E., Hamill, J., Kamen, G., and Whittlesey, S.N. (2014). Research Methods in Biomechanics, Human Kinetics Publisher. [2nd ed.].","DOI":"10.5040\/9781492595809"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1115\/1.3138397","article-title":"A Joint Coordinate System for the Clinical Description of Three-Dimensional Motions: Application to the Knee","volume":"105","author":"Grood","year":"1983","journal-title":"J. Biomech. Eng."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S0966-6362(99)90403-4","article-title":"Variability of gait measurements for typically developing children and children with cerebral palsy","volume":"10","author":"Quigley","year":"1999","journal-title":"Gait Posture"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1037\/1082-989X.1.1.30","article-title":"Forming Inferences about Some Intraclass Correlation Coefficients","volume":"1","author":"Mcgraw","year":"1996","journal-title":"Psychol. Methods"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"050801","DOI":"10.1117\/1.JBO.20.5.050801","article-title":"Tutorial on use of intraclass correlation coefficients for assessing intertest reliability and its application in functional near-infrared spectroscopy\u2013based brain imaging","volume":"20","author":"Li","year":"2015","journal-title":"J. Biomed. Opt."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1302\/0301-620X.86B2.13878","article-title":"Sagittal gait patterns in spastic diplegia","volume":"86","author":"Rodda","year":"2004","journal-title":"J. Bone Jt. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2106\/00004623-198769030-00016","article-title":"Gait patterns in spastic hemiplegia in children and young adults","volume":"69","author":"Winters","year":"1987","journal-title":"J. Bone Jt. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.gaitpost.2004.05.002","article-title":"Human movement analysis using stereophotogrammetry: Part 3. Soft tissue artifact assessment and compensation","volume":"21","author":"Leardini","year":"2005","journal-title":"Gait Posture"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.jbiomech.2010.01.002","article-title":"Non-invasive assessment of soft-tissue artifact and its effect on knee joint kinematics during functional activity","volume":"43","author":"Akbarshahi","year":"2010","journal-title":"J. Biomech."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1016\/j.jbiomech.2015.02.050","article-title":"Surface marker cluster translation, rotation, scaling and deformation: Their contribution to soft tissue artefact and impact on knee joint kinematics","volume":"48","author":"Benoit","year":"2015","journal-title":"J. Biomech."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1016\/j.jbiomech.2015.05.007","article-title":"A model of the soft tissue artefact rigid component","volume":"48","author":"Camomilla","year":"2015","journal-title":"J. Biomech."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/S0966-6362(97)01110-7","article-title":"Tibiofemoral and tibiocalcaneal motion during walking: External vs. skeletal markers","volume":"6","author":"Reinschmidt","year":"1997","journal-title":"Gait Posture"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/PEP.0000000000000659","article-title":"Differentiating between Idiopathic Toe Walking and Cerebral Palsy: A Systematic Review","volume":"32","author":"Schlough","year":"2020","journal-title":"Pediatr. Phys. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/01241398-198803000-00007","article-title":"Differentiation of idiopathic toe-walking and cerebral palsy","volume":"8","author":"Hicks","year":"1988","journal-title":"J. Pediatr. Orthop."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/0167-9457(84)90005-8","article-title":"Kinematic and kinetic patterns in human gait: Variability and compensating effects","volume":"3","author":"Winter","year":"1984","journal-title":"Hum. Mov. Sci."}],"container-title":["Applied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3417\/11\/14\/6515\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:31:06Z","timestamp":1760164266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3417\/11\/14\/6515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,15]]},"references-count":57,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["app11146515"],"URL":"https:\/\/doi.org\/10.3390\/app11146515","relation":{},"ISSN":["2076-3417"],"issn-type":[{"type":"electronic","value":"2076-3417"}],"subject":[],"published":{"date-parts":[[2021,7,15]]}}}