Grant: Operating Grant: SickKids-CIHR-IHDCYH New Investigator Grants

Markerless movement assessments represent a major advancement in clinical assessments and research. These assessments are used to inform care for children with mobility impairments which is a top priority for families. However, their validity and reliability have not been established in children. How broadly they will improve the patient experience and expand access has not been explored. We will systematically evaluate the strengths and limitations of markerless gait analysis to understand its utility for use in children with mobility impairments. 140 typically developing children and 60 children with mobility impairments will undergo simultaneous gait assessment with marker-based and markerless systems. Concurrent validity will be explored through a multimodal approach appropriate to understand different aspects of the comparison of individual joint movements in each plane and summary metrics describing the gait such as stride length and the Gait Profile Score. Test-retest reliability will be evaluated in the typically developing group who will complete an additional markerless only assessment with the order of conditions randomized. Children referred by their clinicians for gait assessment who are unable to undergo marker-based assessment will be offered a markerless assessment. The ability to complete the assessment, demographics, and clinical characteristics will be explored with descriptive statistics. In addition, all participants will complete a participant experience questionnaire with responses presented with descriptive statistics. This project has direct implications for individual patient care and the conduct of clinical research into pediatric mobility impairments as well as basic research in the development of movement. Not only will this project improve care, but it also will demonstrate the degree to which markerless assessments improve access to care and research. This project involves the next critical steps toward the realization of the most significant change in the assessment of movement since the introduction of computers for analysis.