The study, led by Children’s Hospital Los Angeles, found strong agreement among physicians at accredited centers who evaluated the same gait analysis data. The findings mark an improvement over earlier research and reinforce the clinical value of gait analysis in decision-making for children with complex walking disorders.
The results were presented June 11 by first author Alison Hanson, PT, MSPT—Manager of the John C. Wilson Jr. Motion and Sports Analysis Laboratory at CHLA—at the 2026 Annual Meeting of the Gait and Clinical Movement Analysis Society in Phoenix.
“Gait analysis is becoming increasingly reliable, both in identifying problems and in guiding treatment decisions,” says Robert M. Kay, MD, senior author of the study and Director of the Jackie and Gene Autry Orthopedic Center at Children’s Hospital Los Angeles. “What we’re seeing reflects years of improved standardization and training across accredited centers.”
A critical role
The Motion Lab at CHLA is one of only 20 accredited gait labs in the United States. The lab is one of the busiest in the U.S., evaluating more than 400 children every year.
Gait analysis plays a critical role in pediatric orthopedic care, with studies showing it changes surgical plans nearly 90% of the time and significantly decreases the rates of reoperation in children who undergo pre-operative gait analysis.
But despite this clinical value, gait analysis interpretation has sometimes faced scrutiny, with early research suggesting variability across institutions—particularly when it came to treatment decisions.
“Over time, there’s been more rigor applied to how gait labs operate and who can be accredited,” says Dr. Kay, Associates Chair in Orthopedics at CHLA. “There has also been improved training in the application of computerized gait analysis data. We wanted to see if that standardization and training have improved reliability over time, particularly across different institutions.”
Key findings
The multicenter study has so far evaluated data from physicians at nine institutions who reviewed five different cases. Early results show that:
- Across all gait variables evaluated, physicians demonstrated greater than 60% agreement, with many measures showing substantially higher consistency.
- Agreement in identifying gait problems—such as abnormal ankle motion, knee flexion, or hip positioning—generally ranged from approximately 63% to more than 80%.
- For certain findings, agreement approached near-perfect levels. For example, identification of excessive plantarflexion in stance showed agreement exceeding 90%.
- Treatment recommendations also showed strong consistency for many foot and ankle procedures—including 85% agreement for calf muscle lengthening and as high as 95% for posterior tibialis interventions.
“Agreement overall was still higher for identifying problems than for selecting treatments, but that is expected given the range of interventions available for gait abnormalities,” Dr. Kay notes. “The overall consistency seen in both areas represents a meaningful improvement over prior studies.”
Next steps
The study is ongoing, with physician reviewers planning to analyze a total of 15 cases.
For clinicians, the early findings reinforce an important takeaway: Gait analysis is not only a powerful tool; it’s also highly reliable. And a key part of that reliability is the rigor applied by accredited labs.
“Standardization of how you do the test and how you interpret it is very important, and this is best undertaken at high-volume centers like CHLA,” Dr. Kay says. “These are complex problems, and the more reliable our data and interpretation are, the better decisions we can make for patients.”
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