Walking Route List Nijmegen

Abstract

The Ganganalyselijst Nijmegen (GALN), or Nijmegen Gait Analysis List, is a structured, standardized observational assessment tool designed primarily for use by a physiotherapist. It systematically evaluates five distinct phases of the human gait cycle. The instrument comprises 26 total items, divided into 13 items per side of the body, specifically targeting the scoring of abnormal phenomena within the walking pattern. Each item focuses on specific components of the gait, assessing the function and movement of various body parts including the trunk, pelvis, hip, knee, and ankle. The GALN provides a framework for the clinician to observe, describe, and standardize the documentation of gait analysis in a systematic manner.

Keywords

Gait assessment, locomotion, lower extremity, physiotherapy, movement system, standardized observation, clinical assessment, performance measure, Nijmegen.

Authors

Brunnekreef JJ, van Uden CJT (2004)

Purpose

The primary purpose of the Ganganalyselijst Nijmegen (GALN) is to provide a structured and standardized method for the clinical observation and description of pathological or atypical gait analysis. By breaking down the complex movement of walking into five defined phases and 26 specific items, the GALN ensures that all critical aspects of the locomotion pattern are systematically reviewed, minimizing observer bias inherent in unstructured clinical assessments.

This systematic approach is essential for identifying specific biomechanical deviations related to the musculoskeletal system or neurological impairments. For the physiotherapist, the tool serves not only as a diagnostic aid but also as a baseline measure against which the efficacy of therapeutic interventions can be tracked over time. The focus on detailed assessment of the trunk and lower extremity joints allows for targeted treatment planning.

Construct

The GALN is designed to measure the kinematic performance of the human gait cycle. The fundamental construct assessed is the degree of deviation from a normative walking pattern. It is an observational performance measure, focusing on physical function rather than psychological traits.

The scale operationalizes the gait cycle by dividing it into five discrete phases, ensuring comprehensive coverage of both the stance phase and the swing phase. The instrument systematically evaluates the quality of movement across multiple joints—specifically the hip, knee, and ankle—as well as the stability provided by the trunk and pelvis. The final score reflects the overall severity and complexity of the observed gait pathology.

Validity

While specific detailed psychometric studies may be housed in the original KNGF documentation, the validity of the GALN, as a structured observational tool, typically relies heavily on content validity and criterion validity. Content validity is generally established through expert consensus among physiotherapists and movement scientists, ensuring that the 26 items comprehensively cover all critical aspects of pathological gait phenomena.

Criterion validity is often demonstrated by correlating GALN scores with objective, laboratory-based measures, such as 3D motion capture systems or force plates, which provide gold-standard kinematic data. Furthermore, construct validity is supported if the GALN successfully differentiates between patients with known gait disorders (e.g., post-stroke, orthopedic injuries) and healthy controls, reflecting its ability to accurately measure the intended construct of gait deviation.

Reliability

For an observational clinical tool like the GALN, reliability is paramount, particularly inter-rater reliability and test-retest reliability. High inter-rater reliability is crucial, ensuring that different clinicians observing the same patient arrive at comparable scores, which validates the standardization provided by the detailed checklist format.

Test-retest reliability assesses the consistency of the measurement when administered to the same patient under stable clinical conditions at different points in time. Adequate reliability suggests that changes in scores genuinely reflect changes in the patient’s gait pattern due to rehabilitation or progression of a condition, rather than measurement error. Training and adherence to the standardized scoring procedures outlined in the instrument manual are essential for maintaining high reliability.

Factor Analysis

As the Ganganalyselijst Nijmegen functions primarily as a standardized checklist for clinical observation, traditional exploratory or confirmatory factor analysis (CFA/EFA) used for latent psychological constructs is less common. However, factor analysis, or related statistical techniques, may be employed to examine the internal structure of the scale and confirm that the 26 items logically group into the five intended gait phases, supporting the conceptual model.

Analysis of internal consistency, often measured using techniques like Cronbach’s alpha, is more commonly reported for such scales to ensure that items within the same gait phase subscale are homogeneous and contribute consistently to the overall measurement of gait pathology. This verifies that the 13 items assigned to each side effectively measure the components of the five defined gait phases.

Instrument

Test Type: Performance

Format: Structured Observational Checklist (26 items total, 13 per side)

Language Available: Primarily Dutch (Original language)

Population Group: Clinical Populations (Patients requiring gait analysis)

Age Group: Children, Adults, Elderly

Population Details: Applicable to individuals presenting with pathology of the movement system or the musculoskeletal system, specifically affecting the lower extremity.

Test Methodology: Clinical observation by a trained physiotherapist or movement specialist during locomotion. The observer scores deviations across five phases of gait using the 26 items related to the trunk, pelvis, hip, knee, and ankle.

The original Explanation Form (Toelichtingsformulier) can be downloaded here: GALN-form.pdf

The original Measurement Instrument (Meetinstrument) can be downloaded here: GALN-meetinstr-kngf-2018.pdf

Keywords

Ganganalyselijst Nijmegen, GALN, locomotion assessment, movement disorders, physiotherapy, clinical observation, performance instrument, musculoskeletal system, gait cycle.

Authors

Author ORCID Identifier: N/A (Information not provided in source material)

Affiliation Email addresses: N/A (Information not provided in source material)

Correspondence Address: N/A (Information not provided in source material)

Permissions & Fee and Test Year

Test Year: 2004

Permissions and Fees: The scale was developed by Brunnekreef JJ and van Uden CJT. As a standardized clinical instrument often used within physical therapy guidelines (such as those endorsed by KNGF in the Netherlands), its clinical application is generally permitted for trained professionals. Licensing fees and specific usage permissions for research or commercial use should be sought directly from the authors or the relevant authorizing body.

Reference’s

• Brunnekreef JJ, van Uden CJT. (2004). Ganganalyselijst Nijmegen (GALN).
• KNGF (Koninklijk Nederlands Genootschap voor Fysiotherapie) documentation regarding standardized measurement instruments (2018 revision referenced in instrument PDF).

Items of the Ganganalyselijst Nijmegen

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The Ganganalyselijst Nijmegen (GALN) assesses 5 phases of gait. These 5 phases are subdivided into 13 items per side (total 26 items) to score the abnormal phenomena in the walking pattern. Each item contains a component of the walking pattern, whereby the various body parts (romp, bekken, heup, knie, enkel) are assessed on the basis of questions. The GALN allows the physiotherapist the possibility to systematically and standardized observe and describe their gait analysis.

The assessment structure focuses on the following body parts:

• romp (trunk)
• bekken (pelvis)
• heup (hip)
• knie (knee)
• enkel (ankle)