Locomotor Requirements for Bipedal Locomotion: A Delphi Survey

• Published in: Physical therapy Vol. 94; no. 1; pp. 52 - 67
• Main Authors: Hedman, Lois Deming, Morris, David M, Graham, Cecilia L, Brown, Cynthia J, Ford, Matthew P, Ingram, Debbie A, Hilliard, Marjorie J, Salzman, Alice J
• Format: Journal Article
• Language: English
• Published: United States American Physical Therapy Association 01.01.2014; Oxford University Press
• Subjects: Behavior; Consensus; Delphi Technique; Experts; Female; Gait - physiology; Human locomotion; Humans; Locomotion; Male; Medical societies; Older people; Physical Therapists; Physical therapy; Response rates; School dropouts; Studies; Surveys; Walking; Walking - physiology
• ISSN: 0031-9023; 1538-6724
• DOI: 10.2522/ptj.20120514

Bipedal locomotor control requirements may be useful as classifications for walking dysfunction because they go beyond gait analysis to address all issues contributing to walking dysfunction. The objective of this study was to determine whether locomotor experts could achieve consensus about the requirements for bipedal locomotion. Locomotor experts from physical therapy and other related professions participated in an electronic mail Delphi survey. Experts recommended additions, deletions, rewording, and merges for 15 proposed locomotor requirements in round 1. In rounds 2 and 3, panelists commented on and rated the validity, mutual exclusiveness, and understandability of each requirement. Consensus was defined a priori as: (1) 75% or more panelists agree or strongly agree that a requirement is valid, mutually exclusive, and understandable in round 3; (2) no difference between round 2 and 3 ratings with kappa coefficients ≥.60; and (3) a reduction in panelists who commented and convergence of comments between rounds 1 and 3. Content analysis and nonparametric statistics were used. Fifty-eight panelists reached full consensus on 5 locomotor requirements (Initiation, Termination, Anticipatory Dynamic Balance, Multi-Task Capacity, and Walking Confidence) and partial consensus for 7 other requirements. There were no significant differences in ratings between rounds 2 and 3, and there was a decrease in the percentage of panelists who commented between rounds 1 and 3. The study's 6-month time frame may have contributed to panelist attrition. Locomotor experts achieved consensus on several bipedal locomotor requirements. With validation, these requirements can provide the framework for a clinically feasible and systematic diagnostic tool for physical therapists to categorize locomotor problems and standardize intervention for walking dysfunction.