Academic Journal
Automated gait classification: Comparison of automated algorithms to expert classification.
| Title: | Automated gait classification: Comparison of automated algorithms to expert classification. |
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| Authors: | Kruger KM; Shriners Children's Chicago, 2211 N. Oak Park Ave., Chicago, IL 60707, USA; Orthopedic and Rehabilitation Engineering Center, Marquette University & Medical College of Wisconsin, 1250 W. Wisconsin Ave., Milwaukee, WI 53233, USA. Electronic address: karen.kruger@marquette.edu., Krzak JJ; Shriners Children's Chicago, 2211 N. Oak Park Ave., Chicago, IL 60707, USA; Midwestern University, Physical Therapy Program, 555 31(st) St., Downers Grove, IL 60515, USA., Chafetz RS; Shiners Children's Philadelphia, 3551 N Broad St, Philadelphia, PA 19140, USA., Sienko S; Shriners Children's Portland, 3101 SW Sam Jackson Park Rd, Portland, OR 97239, USA., Bauer JP; Shriners Children's Portland, 3101 SW Sam Jackson Park Rd, Portland, OR 97239, USA. |
| Source: | Clinical biomechanics (Bristol, Avon) [Clin Biomech (Bristol)] 2026 Jul; Vol. 137, pp. 106864. Date of Electronic Publication: 2026 May 09. |
| Publication Type: | Journal Article; Comparative Study |
| Language: | English |
| Journal Info: | Publisher: Elsevier Science Country of Publication: England NLM ID: 8611877 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1271 (Electronic) Linking ISSN: 02680033 NLM ISO Abbreviation: Clin Biomech (Bristol) Subsets: MEDLINE |
| Imprint Name(s): | Publication: 1995- : Oxford : Elsevier Science Original Publication: Bristol, UK : J. Wright, c1986- |
| MeSH Terms: | Cerebral Palsy*/physiopathology , Gait Analysis*/methods , Gait Disorders, Neurologic*/physiopathology , Pattern Recognition, Automated*/methods , Classification Algorithms*, Child ; Female ; Humans ; Male ; Automation ; Biomechanical Phenomena ; Observer Variation ; Reproducibility of Results |
| Abstract: | Background: Accurate classification of gait patterns in children with cerebral palsy (CP) is critical for guiding treatment but requires expert interpretation of data. Automated methods have potential to improve consistency and scalability; however, clinically meaningful automated tools are limited. This work aimed to determine if automated algorithms based on established gait classifications can reproduce expert clinical classification in children with CP. Methods: An automated MATLAB algorithm was developed to assign gait classifications using two established systems (Rodda & Graham and Rozumalski & Schwartz). A sample of children with CP who met criteria for crouch gait underwent automated classification. Three expert gait analysts independently classified all trials using standardized definitions corresponding to each system. Fleiss's κ quantified inter-rater reliability, while Cohen's κ, weighted κ, percent agreement, and macro F1 scores quantified agreement between each reviewer and the automated classifications. Findings: Inter-rater reliability among reviewers was substantial for Rodda & Graham (κ = 0.753), with high agreement between reviewers. Inter-rater reliability among reviewers was moderate for Rozumalski & Schwartz (κ = 0.456) and agreement between raters was lower and more variable, with some classifications demonstrating full disagreement among reviewers. Interpretation: Automated gait classification based on quantitative gait criteria can achieve agreement with gait analysis experts for systems with clear biomechanical boundaries. More complex cluster-based systems yield lower agreement, reflecting inherent ambiguity in cluster overlap. These findings support use of automated tools as reliable, objective ground-truth for large-scale analyses and for training markerless or video-based assessment algorithms aimed at expanding gait evaluation beyond specialized motion laboratories. (Copyright © 2026. Published by Elsevier Ltd.) |
| Competing Interests: | Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Karen Kruger reports financial support was provided by National Institutes of Health. Karen Kruger reports financial support was provided by Shriners Children's. Joseph Krzak reports financial support was provided by Shriners Children's. Susan Sienko reports financial support was provided by Shriners Children's. Jeremy Bauer reports financial support was provided by Shriners Children's. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Grant Information: | R01 HD118205 United States HD NICHD NIH HHS |
| Contributed Indexing: | Keywords: Automated classification; Cerebral palsy; Clinical decision support; Gait analysis; Motion analysis |
| Entry Date(s): | Date Created: 20260522 Date Completed: 20260612 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13288829 |
| DOI: | 10.1016/j.clinbiomech.2026.106864 |
| PMID: | 42172880 |
| Database: | MEDLINE |
| ISSN: | 1879-1271 |
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| DOI: | 10.1016/j.clinbiomech.2026.106864 |