Gait Outcome Measures Flashcards
Gait falls under which domains within the WHO ICF Model?
Activity
Participation
Psychometric Properties of Outcome Measures
Validity
Reliability - Interrater vs. Intrarater
Minimal Detectable Change (MDC): Change beyond measurement error
Minimal Clinically Important Difference (MCID): Clinically significant to patient
Ceiling (too easy) vs. Floor (too difficult) Effect
Sensitivity: Test’s ability to obtain a positive test when the target condition is present
Specificity: Test’s ability to obtain a negative test when the target condition is present
Generic Outcome Measures
Relevant for patients with varying conditions / levels of function (intended for use with all)
Advantages: Normative data for specific groups (easy to compare across patient groups / generalize)
Disadvantages: Ceiling and floor effects more likely
Disease-Specific Outcome Measures
Reflects a specific health condition and items relate more to the disease
Advantages: More specifically reflects a certain condition and the relationship between domains of the ICF model
Disadvantages: Does NOT allow comparisons across different groups
Generic Gait Outcome Measure Examples
Temporal: 10MWT / 6MWT / TUG
Functional: TUG / FGA / Four Square Step Test
Disease Specific Outcome Measure Examples
“L” Test of Functional Mobility / Amputee Mobility Predictor: Lower limb amputation
DGI / FGA: Vestibular disorders
Modified Emory Functional Ambulation Profile / Functional Ambulation Classification: Stroke
HiMAT: TBI
Walking Index for SCI (WISCI II) / SCI-FAI: SCI
Core Measures for Adults w/ Neurologic Conditions
Berg Balance Scale
FGA - Gait
10MWT - Gait
6MWT - Gait
5 Times Sit to Stand
Activities - Specific Balance Confidence (ABC) Scale - Gait
Functional Gait Assessment
Balance during walking
Assesses postural stability during various walking tasks
Developed from DGI to overcome ceiling effect (3 new items - walking w/ EC / walking backwards / walking w/ narrow BOS)
< or = 22/30 means fall risk in non-specific older adults
< 15-18/30 means fall risk in patients with Parkinson’s Disease
10 Meter Walk Test (10mWT)
Assesses gait speed (referred to as “6th vital sign”)
<0.4 m/s = more likely to be household ambulators
0.4-0.8 m/s = limited community ambulators
> 0.8 m/s = community ambulators
Above cutoff scores are related to stroke patients
<0.7 m/s is indicative of increased risk of adverse events (fall, hospitalization, etc.)
6 Minute Walk Test (6MWT)
Endurance
“Walk as far as possible for 6 minutes” - 12 meter laps
Norms:
60-69: 572 meters (M) / 538 meters (F)
70-79: 527 meters (M) / 471 (F)
80-89: 417 meters (M) / 392 meters (F)
Activity Specific Balance Confidence Scale (ABC)
Assesses participation domain
Self report on level of self confidence with multiple tasks related to walking
Higher score = greater confidence
L-Test of Functional Mobility
Modified version of TUG for individuals with LE amputation
Walking in “L” shape - requires turns to both the right and left
Amputee Mobility Predictor
Used to justify prosthetics (assesses mobility of people with lower limb amputation prior to prosthetic fitting / predicts function following prosthetic prescription)
Measures ambulatory potential of lower limb amputees w/ and without the use of prosthesis
Static / dynamic sitting / standing activities
Transfer / gait skills of progressing difficulty
What takes priority when selecting an outcome measure to administer?
ANPT core measures
Dynamic Gait Index (DGI)
Assesses individual’s ability to modify balance while walking to changing demands
Appropriate for patients with vestibular disorders and higher functioning individuals
Max score of 24: < or = 19 indicates fall risk / >22/24 = safe ambulators
