Validation of the Self-Assessed Dynamic Gait Index in People with Multiple Sclerosis

Abstract

Background and Purpose The Dynamic Gait Index (DGI) is a validated clinical measure of walking ability in people with multiple sclerosis (MS). There is need for a self-assessed version of the DGI that can be conducted remotely and that demonstrates concurrent validity with the original DGI in people with MS. We therefore developed a self-assessed Dynamic Gait Index (sDGI). The purpose of this study is to evaluate the relationship between the sDGI, clinically-assessed DGI, and falls in people with MS with gait impairment. Methods We will enroll 50 ambulatory people with MS with gait impairment. Participants will complete the sDGI (online questionnaire) and then, within 4-weeks, the DGI (in-person evaluation by a physical therapist). Other outcome measures include: modified Telephone Interview for Cognitive Status (TICS-M) and self-reported fall history in the past 3 months. We will calculate concordance between the sDGI and DGI, and use linear regression to determine if concordance is impacted by cognition. The ability of the sDGI to identify fallers will be evaluated using the receiver operating characteristic curve. Results At time of submission, 41 participants are enrolled, 31 have completed the study. Anticipated date of study completion is March 2023. Full study results will be presented at the meeting. Discussion The sDGI has potential to be used by physicians, physical therapists, and others to remotely assess walking ability and identify fallers in people with MS. Information from this study will determine how self-assessment of walking ability compares with clinically-assessed walking ability in people with MS. Our study will also determine if cognition impacts the validity of the sDGI. If concordance between sDGI and DGI is lower in those with worse cognitive performance, users of the sDGI might exercise greater caution using this measure to approximate DGI and predict fall risk in individuals with cognitive impairment. The Dynamic Gait Index (DGI) is a validated clinical measure of walking ability in people with multiple sclerosis (MS). There is need for a self-assessed version of the DGI that can be conducted remotely and that demonstrates concurrent validity with the original DGI in people with MS. We therefore developed a self-assessed Dynamic Gait Index (sDGI). The purpose of this study is to evaluate the relationship between the sDGI, clinically-assessed DGI, and falls in people with MS with gait impairment. We will enroll 50 ambulatory people with MS with gait impairment. Participants will complete the sDGI (online questionnaire) and then, within 4-weeks, the DGI (in-person evaluation by a physical therapist). Other outcome measures include: modified Telephone Interview for Cognitive Status (TICS-M) and self-reported fall history in the past 3 months. We will calculate concordance between the sDGI and DGI, and use linear regression to determine if concordance is impacted by cognition. The ability of the sDGI to identify fallers will be evaluated using the receiver operating characteristic curve. At time of submission, 41 participants are enrolled, 31 have completed the study. Anticipated date of study completion is March 2023. Full study results will be presented at the meeting. The sDGI has potential to be used by physicians, physical therapists, and others to remotely assess walking ability and identify fallers in people with MS. Information from this study will determine how self-assessment of walking ability compares with clinically-assessed walking ability in people with MS. Our study will also determine if cognition impacts the validity of the sDGI. If concordance between sDGI and DGI is lower in those with worse cognitive performance, users of the sDGI might exercise greater caution using this measure to approximate DGI and predict fall risk in individuals with cognitive impairment.