4-item Dynamic Gait Index: Difference between revisions

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== Objective  ==
== Introduction ==


[[Image:Blender3D NormalWalkCycle.gif|right]]  
[[Image:Blender3D NormalWalkCycle.gif|right]]  


The purpose of this measure is to test the psychometric properties of a short form of the [[Dynamic Gait Index]] (DGI) for the clinical measurement of walking function in people with balance and vestibular disorders.<ref name="Marchetti" />
The 4-Item Dynamic Gait Index is a shortened version of the [[Dynamic Gait Index]] (DGI) utilizing only the first four items.  It is used for the clinical assessment of walking function and has been examined in patients with [[balance]] deficits, [[Vestibular Pathologies|vestibular disorders]], and those post [[stroke]].<ref name=":0">Lin JH, Hsu MJ, Hsu HW, Wu HC, Hsieh CL. [http://stroke.ahajournals.org/cgi/content/abstract/STROKEAHA.110.589739v1 Psychometric Comparisons of 3 Functional Ambulation Measures for Patients With Stroke]. Stroke. 2010 Jul 29; 41:9.</ref><ref name="Marchetti">Marchetti GF, Whitney SL. [http://ptjournal.apta.org/cgi/content/full/86/12/1651 Construction and validation of the 4-item dynamic gait index]. Physical Therapy, 2006 Dec;86(12):1651-60.</ref>
== Intended Population  ==
== Administering Test ==
 
People with balance and vestibular disorders having difficulty walking.  
 
This test was specifically constructed to be administered without using any equipment (cf. DGI requires cones etc.).  
 
== Test  ==
 
4 items were selected for the reduced-item DGI:  
#horizontal head turns
#vertical head turns
#gait on level surfaces
#changes in gait speed<br>
 
== Scoring  ==
 
With regard to the use of the 4-item DGI as a screening tool for falls, the higher specificity of the 4-item DGI suggests that a closer evaluation of fall risk factors is indicated if an individual has a score of less than 10 of 12.
 
== Original Reference  ==
 
Marchetti GF, Whitney SL. [http://ptjournal.apta.org/cgi/content/full/86/12/1651 Construction and validation of the 4-item dynamic gait index]. Physical Therapy, 2006 Dec;86(12):1651-60.<ref name="Marchetti" />  
 
== Evidence  ==


The clinical psychometric properties of the 4-item DGI were equivalent or superior to those of the 8-item test. The 4-item DGI can be used by clinicians to measure gait in people with balance and vestibular disorders without compromising important clinical measurement characteristics<ref name="Marchetti">Marchetti GF, Whitney SL.  [http://ptjournal.apta.org/cgi/content/full/86/12/1651 Construction and validation of the 4-item dynamic gait index]. Physical Therapy, 2006 Dec;86(12):1651-60.</ref>.
The first four items utilized from the DGI include:
#Horizontal head turns<ref name="Marchetti" />
#Vertical head turns<ref name="Marchetti" />
#Gait on level surfaces<ref name="Marchetti" />
#Changes in gait speed<ref name="Marchetti" />


=== Reliability  ===


[[Image:DGI4 Vs DGI8.jpg|center|500x650px]]


=== Validity ===
Each of the four items are scored on an ordinal scale from 0-3 with higher numbers indicating better performance of the specified task.  Additionally, each item has specific criteria that must be met to be granted a specific score number. The test has a total score out of 12.<ref name="Marchetti" />


[[Image:DGI4.jpg|left|750x600px]]
Unlike the full DGI, the 4-Item Dynamic Gait Index does not require access to stairs or the use of obstacles. Something to measure and mark specific distances is still needed though.<ref name="Marchetti" />


[[Image:DGI4 Validation.jpg|center|450x600px]]  
{{#ev:youtube|hgk6fkU_eJc}}<ref>Geoffrey Coe. 4 Item DGI. Available from: https://www.youtube.com/watch?v=hgk6fkU_eJc [last accessed 10/23/2021]</ref>


=== Miscellaneous  ===
== Psychometric Properties ==


[[Dynamic Gait Index|Dynamic Gait Index]], the '''4-item Dynamic Gait Index''', and the [[Functional Gait Assessment|Functional Gait Assessment]] show sufficient validity, responsiveness, and reliability for assessment of walking function in patients with stroke undergoing rehabilitation, but the Functional Gait Assessment is recommended for its psychometric properties<ref>Lin JH, Hsu MJ, Hsu HW, Wu HC, Hsieh CL. [http://stroke.ahajournals.org/cgi/content/abstract/STROKEAHA.110.589739v1 Psychometric Comparisons of 3 Functional Ambulation Measures for Patients With Stroke]. Stroke. 2010 Jul 29; online article ahead of print</ref>.
The 4-Items Dynamic Gait Index has been found be both valid and reliable for the assessment of walking function in patients with [[balance]] deficits, [[Vestibular Pathologies|vestibular disorders]], and those post [[stroke]].<ref name=":0" /> <ref name="Marchetti" /> Additionally, it possess [[Psychometric Properties|psychometric properties]] at least on par with, if not better than, the full DGI.<ref name="Marchetti" />  It has been shown to have a minimum detectable change (MDC) of 2.3 points.<ref name=":0" />  


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Latest revision as of 20:47, 16 March 2023

Original Editor - Rachael Lowe. Top Contributors - Jeremy Bryan, Rachael Lowe, Admin, Gayatri Jadav Upadhyay, Laura Ritchie, Wendy Walker, Tony Lowe, Kim Jackson, WikiSysop, Evan Thomas, Naomi O'Reilly, Karen Wilson and Lucinda hampton

Introduction[edit | edit source]

Blender3D NormalWalkCycle.gif

The 4-Item Dynamic Gait Index is a shortened version of the Dynamic Gait Index (DGI) utilizing only the first four items. It is used for the clinical assessment of walking function and has been examined in patients with balance deficits, vestibular disorders, and those post stroke.[1][2]

Administering Test[edit | edit source]

The first four items utilized from the DGI include:

  1. Horizontal head turns[2]
  2. Vertical head turns[2]
  3. Gait on level surfaces[2]
  4. Changes in gait speed[2]


Each of the four items are scored on an ordinal scale from 0-3 with higher numbers indicating better performance of the specified task. Additionally, each item has specific criteria that must be met to be granted a specific score number. The test has a total score out of 12.[2]

Unlike the full DGI, the 4-Item Dynamic Gait Index does not require access to stairs or the use of obstacles. Something to measure and mark specific distances is still needed though.[2]

[3]

Psychometric Properties[edit | edit source]

The 4-Items Dynamic Gait Index has been found be both valid and reliable for the assessment of walking function in patients with balance deficits, vestibular disorders, and those post stroke.[1] [2] Additionally, it possess psychometric properties at least on par with, if not better than, the full DGI.[2] It has been shown to have a minimum detectable change (MDC) of 2.3 points.[1]


References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 Lin JH, Hsu MJ, Hsu HW, Wu HC, Hsieh CL. Psychometric Comparisons of 3 Functional Ambulation Measures for Patients With Stroke. Stroke. 2010 Jul 29; 41:9.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Marchetti GF, Whitney SL. Construction and validation of the 4-item dynamic gait index. Physical Therapy, 2006 Dec;86(12):1651-60.
  3. ↑ Geoffrey Coe. 4 Item DGI. Available from: https://www.youtube.com/watch?v=hgk6fkU_eJc [last accessed 10/23/2021]
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