The reliability of three-dimensional kinematic gait measurements: a systematic review

Background/Aim: Three-dimensional kinematic measures of gait are routinely used in clinical gait analysis and provide a key outcome measure for gait research and clinical practice. This systematic review identifies and evaluates current evidence for the inter-session and inter-assessor reliability of threedimensional kinematic gait analysis (3DGA) data. Method: A targeted search strategy identified reports that fulfilled the search criteria. The quality of fulltext reports were tabulated and evaluated for quality using a customised critical appraisal tool. Results: Fifteen full manuscripts and eight abstracts were included. Studies addressed both within assessor and between-assessor reliability, with most examining healthy adults. Four full-text reports evaluated reliability in people with gait pathologies. The highest reliability indices occurred in the hip and knee in the sagittal plane, with lowest errors in pelvic rotation and obliquity and hip abduction. Lowest reliability and highest error frequently occurred in the hip and knee transverse plane. Methodological quality varied, with key limitations in sample descriptions and strategies for statistical analysis. Reported reliability indices and error magnitudes varied across gait variables and studies. Most studies providing estimates of data error reported values (S.D. or S.E.) of less than 58, with the exception of hip and knee rotation. Conclusion: This review provides evidence that clinically acceptable errors are possible in gait analysis. Variability between studies, however, suggests that they are not always achieved