Use of the Gait Abnormality Rating Scale in Individuals with Neurological Impairment

Abstract

1808 The Gait Abnormality Rating Scale (GARS) is a simple observational assessment tool designed to evaluate gait and predict risk of falling among older adults. The use of the GARS in individuals with neurological impairment has not been previously reported. PURPOSE: The purpose of this research was to investigate the use of the GARS and its shortened modified-version, GARS-M, in persons with neurological impairment. More specifically, this research examined how scores on the GARS and GARS-M related to other commonly used clinical measures of gait and balance. METHODS: GARS and GARS-M scores were determined via videotape analysis for individuals with multiple sclerosis (n = 11), cerebrovascular accident (n = 8) and Parkinson's disease (n = 7) who could ambulate independently without an assistive device. Gait and balance was also assessed using the Berg Balance Scale (BBS), Timed “Up & Go” (TUG) and gait speed. Additionally, energy cost of walking (VO2 ml kg−1m−1) was determined via open-circuit spirometry during a 5-minute timed walk. RESULTS: Spearman rank-order correlation coefficients were used to determine the relationship between GARS and GARS-M scores and the other measures of gait and balance. The GARS demonstrated poor to moderate associations with VO2 ml kg−1m−1 (r = 0.29, p = 0.15), BBS (r = −0.46, p<0.05), gait speed (r = −0.59, p<0.01) and the TUG (r = 0.66, p<0.00) respectively. The GARS-M also demonstrated poor to moderate associations with VO2 ml kg−1m−1 (r = 0.29, p = 0.15), BBS (r = −0.50, p<0.01), gait speed (r = −0.47, p<0.05) and the TUG (r = 0.62, p<0.00) respectively. CONCLUSION: The GARS and GARS-M may be useful for evaluating certain aspects of gait and balance but may not adequately address important characteristics of gait that are related to the energy cost of walking. Use of the GARS does not seem to afford any additional benefits over the shorter and easier to use GARS-M. Development of simple clinical tools that better reflect the efficiency of gait and movement in persons with neurological disorders is warranted.