Reliability of a New Clinical Gait Assessment Scale for Children with Idiopathic Toe Walking Gait–A Pilot Study

Eglal Ali, Anna Len, Wen Ling, Smita Rao

Research output: Contribution to journalArticlepeer-review


Aims: Children with idiopathic toe walking (ITW) gait are increasingly referred to physical therapists. The purpose of this study was to evaluate the intra-rater and inter-rater reliability of the Clinical Gait Assessment Scale (CGAS), a newly developed observational rating scale. Methods: Four raters evaluated videos of four children. Foot, arm and head/trunk movement was scored as children walked over four surfaces. Intra-class correlation coefficients (ICC), model (3,k) were calculated to determine intra-rater and inter-rater reliability of each dependent variable. Results: The key findings of this study indicate robust intra- and inter-rater reliability, particularly of the foot (Inter-rater reliability, ICC (3,2)=0.9) and head and trunk (Inter-rater reliability, ICC (3,2)=1.0) subsections. Arm movements were more challenging to rate and showed moderate reliability (Inter-rater reliability, ICC (3,2)=0.7). Highest total impairment score; the highest value occurred while walking on the obstacle course (38 ± 29). Conclusions: Overall, the CGAS showed adequate/acceptable reliability across different surfaces (linoleum, textured surface, narrow base, obstacle), however the obstacle surface was most challenging surface to the rater.

Original languageEnglish (US)
Pages (from-to)669-680
Number of pages12
JournalPhysical and Occupational Therapy in Pediatrics
Issue number6
StatePublished - Nov 1 2020


  • Motor control
  • gait
  • motor learning
  • toe walking

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Occupational Therapy


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