Functional Gait Assessment: Overview, Toolkit and Core Measure

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Why do we get this confusion about functional gait assessment vs. dynamic gait index? Of course, these two tests are the same. In fact, rehab gait assessment scoring explains this.

So, why the Functional Gait Assessment (FGA) when we can easily use the Dynamic Gait index?

Well, the FGA is actually a modification of the Dynamic Gait Index (DGI) that employs higher-level activities to improve the test’s usefulness to patients with vestibular problems.

Indeed, there is more to this functional gait assessment. Read on cause we have included all you need to know.

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What is Functional Gait Assessment?

Functional Gait Assessment (FGA) is an assessment that examines the postural stability and balance during various tasks of patients with Parkinson’s disease, spinal cord injuries, stroke diagnosis, and vestibular abnormalities.

In other words, this assessment is a modification of the Dynamic Gait Index that helps to reduce the ceiling effect and enhance dependability. A podiatrist ministers this assessment.

Meanwhile, FGA is a low-cost, fast, and simple test to conduct in any situation.

On the whole, we can now officially use this assessment in the following populations: those with vestibular problems, geriatric patients, Parkinson’s disease, and people with multiple sclerosis.

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Functional Gait Assessment Overview

The FGA helps to examine postural stability when walking, as well as an individual’s ability to complete several motor activities while walking.

However, this tool acts as a modification of the 8-item Dynamic Gait Index, which helps to increase reliability and eliminate the ceiling effect.

Furthermore, FGA has ten items, and they include: walking on a level surface, change in gait speed, and horizontal and vertical head rotations.

To add, 180° pivot turn, stepping over obstacles, gait with a restricted base of support, gait with eyes closed, reverse gait, and stairs are also part of the items.

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Functional Gait Activities And Their Instructions

The following are the eight FGA activities and their instructions:

  1. Gait flat surface: Walk from here to the next mark at your regular pace.
  2. Change in gait speed: Walk at your regular rate
  3. Gait with horizontal head turns: Start walking normally
  4. Vertical head turns gait: Begin walking at your usual pace.
  5. Gait and pivot turn: Start walking normally.
  6. Walk normally after stepping over the obstacle.
  7. Begin walking normally after stepping past barriers.
  8. Steps: As you would at home, walk up these steps.

To a large extent, these activities help to assess the subject’s ability to change the balance in order to accommodate a wide variety of motions while walking without falling.

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What is the Equipment Used For Functional Gait Assessment?

To illustrate, some equipment that is used in functional gait assessment includes the following:

  • Stopwatch
  • Use of 2 stacked shoe boxes: obstacle of 9-inch height (22.8 cm)
  • Measuring device to mark off the area. Marked walking area: length=20 feet (ca. 6 meters): width 12 inches (30.48 cm)
  • Sets of steps that are 7.75 – 9 inches high with bilateral rails

What is a Good Functional Gait Assessment Score?

A good functional gait assessment score should be >27/30 for people under the age of 60, while for persons between the ages of 60 and 80, a normal FGA score of >24/30 is indeed normal.

However, for persons above the age of 80, an FGA score greater than 19/30 is good.

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What Are Functional Gait Assessment Rehab Measures?

The Functional Gait Assessment (FGA) rehab measures postural stability and balance in individuals with Parkinson’s disease, spinal cord injuries, stroke diagnosis, and vestibular abnormalities.

However, according to jcore findings, their results show that the functional gait assessment rehab measures are a clinically acceptable and statistically valid assessment of walking balance ability for older persons with balance deficits.


Although, the functional gait assessment rehab measures have items that follow a logical and clinically relevant difficulty range. The inclusion of two challenging items to the FGA has removed the ceiling effect, as seen in the dynamic gait index.

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What is Functional Gait Assessment Scoring?

Functional gait assessment scoring consists of ten items, each of these items scores on a scale of 0 to 3.

In this case, 0 indicates severe impairment, 1 indicates moderate impairment, 2 indicates mild impairment, and 3 indicates normal impairment.


Moreover, the highest possible score is 30, and you can complete the assessment with or without the assistance of the therapist. Here, individuals should walk without the help of another individual.


Meanwhile, when providing walking items, do not walk directly in front of or beside the patient since this paces the patient and might impact their walking speed. Instead, take a half-step behind the patient.

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Functional Gait Assessment Calculator

Based on balance and walking activities, this functional gait assessment calculator assesses fall risk in geriatric, Parkinson’s, and multiple sclerosis patients.


To illustrate, you will find below instructions for each stage of the assessment:

  • Gait level surface – Walking at a typical pace on a flat surface
  • change in gait speed
  • Gait characterized by horizontal head rotations
  • Vertical head turns during gait
  • Pivot turn, and gait
  • Step over the stumbling block
  • Avoiding stumbling blocks

How Does This Functional Gait Assessment Work?

This health test checks gait function in older people or those with Parkinson’s or multiple sclerosis.


Well, the functional gait assessment calculator is built on the index’s original eight activities and provides response scales for each as well as directions on how to complete them throughout the testing.


In fact, the activities help to target the individual’s capacity to change the balance in order to accommodate a wide range of motion when walking.


Furthermore, the test should take no more than 10 to 15 minutes and involves a 20-foot (6.1-meter) clean designated surface, a shoebox, same-size obstacles, and stairs. If necessary, the activities can be carried out with the assistance of an assistive device.

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Dynamic Gait Index vs. Functional Gait Assessment

The Functional Gait Assessment (FGA) is a modification of the Dynamic Gait Index (DGI).

While FGA employs higher-level activities to increase the test’s usefulness to patients with vestibular problems and minimize the ceiling effect of the original test, the DGI measures a person’s ability to change their balance while walking in the presence of external forces.


To illustrate, The Dynamic Gait Index (DGI) serves as a clinical tool to examine gait, balance, and fall risk. It assesses not just steady-state walking but also walking during more difficult activities.

The FGA, on the other hand, is an upgrade of the dynamic index. So, their uses are not far from each other. We can say that it is just a modification of the latter.

FAQs

What is included in a gait assessment?

The patient’s gait may be analyzed in terms of step length, stride length, cadence, cycle duration, and joint angles by examining data from various devices.

What is the highest possible score on the functional gait assessment?

All you need is a stopwatch, a clearly delineated walking path, shoeboxes for barriers, and a set of steps.

In fact, each FGA item is scored from 0 for severe impairment to 3 for normal performance. The maximum potential score is 30.

What are the 8 types of gait?

There are eight primary pathological gaits that can be related to neurological conditions.

To illustrate, they include hemiplegic, spastic diplegic, neuropathic, myopathic, Parkinsonian, choreiform, ataxic (cerebellar), and sensory.

What is functional gait disorder?

A functional gait or movement disorder is defined as the abnormal movement of a component of the body caused by a neural system dysfunction.

Indeed, this is an involuntary movement, and the symptoms are not explained by any other neurological disease or medical condition.

How do you describe normal gait?

A normal mature gait has reciprocal arm swing and heel striking with increasing velocity, cadence, step length, single-limb stance duration, and pelvis span ratio.


Due to enhanced stability and limb length, this truly aids ankle spread while both feet are on the ground.

What is a common dysfunction observed during a gait assessment?

Cerebellar Ataxia is a common dysfunction observed during gait assessment.

Moreover, this gait impairment is frequently found in people who have a cerebellum (a

Conclusion

Having known about functional gait assessment. What next?

Well, consider adding this as a reminder cos you are definitely going to need a functional gait assessment as a Parkinson’s patient.

However, you can as well share this information as a lot of individuals are ignorant about this, and this might be their saving grace. Well, feel free to add more!

References

  • Jcore – The Functional Gait Assessment in Older Adults: Validation Through Rasch Modeling
  • Dictionary – Gait assessment
  • Europepmc – Reliability and Validity of the Functional Gait Assessment in Incomplete Spinal Cord Injury.

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