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Dynamic Gait Index

From Physiopedia

Original Editor - Rachael Lowe

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Contents

Objective

The Dynamic Gait Index (DGI) was developed as a clinical tool to assess gait, balance and fall risk. It evaluates not only usual steady-state walking, but also walking during more challenging tasks.

See the Dynamic Gait Index

Intended Population

Those with poor balance and at risk of falling such as:

Method of Use

[1]

8 functional walking tests are performed by the subject and marked out of three according to the lowest category which applies. 24 is the total individual score possible. Scores of 19 or less have been related to increase incidence of falls.

Equipment needed

Box (Shoebox), Cones (2), Stairs, 20' walkway, 15” wide

Completion Time

15 minutes

Scoring

A four-point ordinal scale, ranging from 0-3. “0” indicates the lowest level of function and “3” the highest level of function.

Total Score = 24

Interpretation  < 19/24 = predictive of falls in the elderly,   > 22/24 = safe ambulators

Evidence

Dynamic Gait Index, the 4-item Dynamic Gait Index, and the 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[2].

Reliability

The DGI showed high reliability and showed evidence of concurrent validity with other balance and mobility scales. It is a useful clinical tool for evaluating dynamic balance in ambulatory people with chronic stroke[3].

DGI total scores, administered by using the published instructions, showed moderate interrater reliability with subjects with vestibular disorders. The DGI should be used with caution in this population at this time, because of the lack of strong reliability[4].

The DGI is a reliable functional assessment tool formultiple sclerosis that correlates inversely with timed walk, showing its concurrent validity[5].

Validity

The DGI, although susceptible to ceiling effects, appears to be an appropriate tool for assessing function in healthy older adults[6]

Responsiveness

In stroke: Moderate responsiveness in depicting change at 2 months & 5 months after treatment[7].

In MS: Scores <12 discriminate between fallers and non-fallers[8].

Miscellaneous

Evaluating a person's performance on items of the DGI may be useful in identifying gait deviations and in evaluating gait improvements as a result of interventions[9].

Recent Related Research (from Pubmed)

References

  1. AV Verleih. Dynamic Gait Index.AVI. Available from: http://www.youtube.com/watch?v=JtnjfsVnPsY[last accessed 25/05/13]
  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; online article ahead of print
  3. Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil. 2007 Nov;88(11):1410-5.
  4. Wrisley D, Walker M, Echternach J, Strasnick B. Reliability of the Dynamic Gait Index in people with vestibular disorders. Arch Phys Med Rehabil. 2003;84:1528–1533
  5. 16McConvey J, Bennett S. Reliability of the Dynamic Gait Index in individuals with multiple sclerosis. Arch Phys Med Rehabil. 2005;86:130–133.
  6. Herman T, Inbar-Borovsky N, Brozgol M, Giladi N, Hausdorff JM. The Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender. Gait Posture. 2009 Feb;29(2):237-41. Epub 2008 Oct 8.
  7. Lin, J. H., Hsu, M. J., et al. (2010). Psychometric comparisons of 3 functional ambulation measures for patients with stroke. Stroke 41(9): 2021-2025
  8. Cattaneo, D., Regola, A., et al. (2006). Validity of six balance disorders scales in persons with multiple sclerosis. Disability and Rehabilitation 28(12): 789-795
  9. Marchetti GF, Whitney SL, Blatt PJ, Morris LO, Vance JM. Temporal and spatial characteristics of gait during performance of the Dynamic Gait Index in people with and people without balance or vestibular disorders. Physical Therapy, 2008 May;88(5):640-51.


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