Measurement Characteristics and Clinical Utility of the Functional Gait Assessment Among Individuals With Vestibular Impairment

Abstract

Vestibular impairment can lead to disequilibrium and postural instability1 and can place an individual at an increased risk for falls. It is important that health care providers screen at-risk patients for imbalance to mitigate fall risk. The Dynamic Gait Index (DGI) is commonly used to evaluate ambulatory balance; however, this measure lacks reliability in persons with vestibular dysfunction and has known ceiling effects in this population.1 The Functional Gait Assessment (FGA) was developed from the DGI to increase its sensitivity to dynamic instability, integrating more demanding task conditions and effectively improving reliability in this population.2 Additionally, the instructions and operational definitions for each item on the FGA were clarified to reduce the likelihood of administration error.3 The FGA takes less than 10 minutes to administer using items typically available in a rehabilitation setting. No formal training is required to administer this measure. The FGA demonstrates excellent concurrent validity with several other measures or indicators commonly considered in individuals with vestibulopathy, including the Dizziness Handicap Inventory and the number of falls a patient has experienced in the previous 4 weeks.2 The minimal detectable change value established for this measure is useful in clinical decision-making to assess clinically significant changes in functional balance. This Rehabilitation Measures Database summary provides a review of the psychometric properties of the FGA in the vestibular population, including reliability, validity, minimum detectable change, and interpretation of the results.