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Main Authors: Reddy, Lauhitya, Donahue, Seth, Bauer, Jeremy, Sienko, Susan, Bagley, Anita, Krzak, Joseph, Eveld, Maura, Kruger, Karen, Chafetz, Ross, Kulkarni, Vedant, Kwon, Hyeokhyen
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2605.11314
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author Reddy, Lauhitya
Donahue, Seth
Bauer, Jeremy
Sienko, Susan
Bagley, Anita
Krzak, Joseph
Eveld, Maura
Kruger, Karen
Chafetz, Ross
Kulkarni, Vedant
Kwon, Hyeokhyen
author_facet Reddy, Lauhitya
Donahue, Seth
Bauer, Jeremy
Sienko, Susan
Bagley, Anita
Krzak, Joseph
Eveld, Maura
Kruger, Karen
Chafetz, Ross
Kulkarni, Vedant
Kwon, Hyeokhyen
contents Cerebral Palsy (CP) is a neurological disorder of movement and the most common cause of lifelong physical disability in childhood. Approximately 75% of children with CP are ambulatory, and accurate gait assessment is central to preserving walking function, which deteriorates by mid-adulthood in a quarter to half of adults with CP. The Rodda and Graham classification system quantifies sagittal-plane gait deviations using ankle and knee z-scores derived from 3D Instrumented Gait Analysis (3D-IGA), but 3D-IGA is expensive and limited to specialized centers, while observational assessment shows only moderate inter-rater agreement. We developed a markerless gait analysis pipeline that quantifies Rodda and Graham knee and ankle z-scores directly from single-view clinical gait videos. Across 1,058 bilateral limb samples from 529 trials of 152 children (88 male, 63 female; age 12.1 $\pm$ 4.0 years; 60 distinct primary diagnoses, cerebral palsy the most common at $n=54$), the sagittal-view model achieved $R^2 = 0.80 \pm 0.02$ and CCC $= 0.89 \pm 0.02$ for knee z-scores and $R^2 = 0.57 \pm 0.02$ and CCC $= 0.72 \pm 0.02$ for ankle z-scores against 3D-IGA. Binary screening for excess knee flexion achieves AUROC $= 0.88$, correctly identifying 83% of affected children, and applying Rodda and Graham rules yields $43 \pm 1$% 7-class accuracy with macro-AUROC $= 0.78 \pm 0.01$, ankle prediction error remaining the primary bottleneck. Beyond cross-sectional screening, continuous z-scores support longitudinal trajectory tracking across visits, providing a quantitative substrate for monitoring disease progression and treatment response unavailable from observational scales. These results demonstrate the feasibility of video-based z-score estimation, excess-flexion screening, and longitudinal trajectory tracking as a path toward scalable, objective gait assessment in low-resource clinical settings.
format Preprint
id arxiv_https___arxiv_org_abs_2605_11314
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Quantifying Rodda and Graham Gait Classification from 3D Makerless Kinematics derived from a Single-view Video in a Heterogeneous Pediatric Clinical Cohort
Reddy, Lauhitya
Donahue, Seth
Bauer, Jeremy
Sienko, Susan
Bagley, Anita
Krzak, Joseph
Eveld, Maura
Kruger, Karen
Chafetz, Ross
Kulkarni, Vedant
Kwon, Hyeokhyen
Computer Vision and Pattern Recognition
Artificial Intelligence
Cerebral Palsy (CP) is a neurological disorder of movement and the most common cause of lifelong physical disability in childhood. Approximately 75% of children with CP are ambulatory, and accurate gait assessment is central to preserving walking function, which deteriorates by mid-adulthood in a quarter to half of adults with CP. The Rodda and Graham classification system quantifies sagittal-plane gait deviations using ankle and knee z-scores derived from 3D Instrumented Gait Analysis (3D-IGA), but 3D-IGA is expensive and limited to specialized centers, while observational assessment shows only moderate inter-rater agreement. We developed a markerless gait analysis pipeline that quantifies Rodda and Graham knee and ankle z-scores directly from single-view clinical gait videos. Across 1,058 bilateral limb samples from 529 trials of 152 children (88 male, 63 female; age 12.1 $\pm$ 4.0 years; 60 distinct primary diagnoses, cerebral palsy the most common at $n=54$), the sagittal-view model achieved $R^2 = 0.80 \pm 0.02$ and CCC $= 0.89 \pm 0.02$ for knee z-scores and $R^2 = 0.57 \pm 0.02$ and CCC $= 0.72 \pm 0.02$ for ankle z-scores against 3D-IGA. Binary screening for excess knee flexion achieves AUROC $= 0.88$, correctly identifying 83% of affected children, and applying Rodda and Graham rules yields $43 \pm 1$% 7-class accuracy with macro-AUROC $= 0.78 \pm 0.01$, ankle prediction error remaining the primary bottleneck. Beyond cross-sectional screening, continuous z-scores support longitudinal trajectory tracking across visits, providing a quantitative substrate for monitoring disease progression and treatment response unavailable from observational scales. These results demonstrate the feasibility of video-based z-score estimation, excess-flexion screening, and longitudinal trajectory tracking as a path toward scalable, objective gait assessment in low-resource clinical settings.
title Quantifying Rodda and Graham Gait Classification from 3D Makerless Kinematics derived from a Single-view Video in a Heterogeneous Pediatric Clinical Cohort
topic Computer Vision and Pattern Recognition
Artificial Intelligence
url https://arxiv.org/abs/2605.11314