Gait Abnormality Rating Scale Research Articles

Evaluation Model of Athletes’ Lower Extremity Training Ability Based on LSTM Algorithm

To achieve intelligent evaluation of the lower limb movement ability of athletes with sports disabilities, this article selects young athletes and middle-aged and young athletes with sports disabilities as the research objects, and healthy young athletes as the control group. Gait videos, GRF and knee angles of the subjects were collected to extract and analyse gait contours and features. The improved Visual Background extractor (ViBe) algorithm has the highest accuracy of 0.978 in PETS2006 video sequences; the recall rate of three algorithms in Highway video sequence is the highest, and the recall rate of improved ViBe algorithm is the highest, up to 0.965. AtƐ=0.7, the accuracy of the improved myloss training set is higher than that corresponding to other values; when the number of iterations is 98, the accuracy rate of improved myloss training set is 0.963, while the accuracy rate corresponding to the cross entropy loss function is 0.945. When the number of iterations is 151, the accuracy rate of the Xeption LSTM model is 0.956, higher than that of other models. Among corresponding mean ± standard deviation (GSA-MS) indicators, the GSA-MS values of Group L are significantly higher than those of group N and group Z (P<0.001). The correlation between GAS indicators and Gait Abnormality Rating Scale (GARS-M) is strong, with a correlation coefficient of 0.90.

Slight pelvic obliquity is normal in a healthy population: a cross-sectional study

PurposePelvic obliquity (PO) has not been extensively investigated, and there is no gold standard for measurement. The PO is essential for surgeons in planning hip arthroplasty, which includes the restoration of leg length discrepancy (LLD). We aimed to establish a normative range of PO angles by measuring healthy individuals without musculoskeletal disorders.MethodsOur study included 134 consecutive cases (70 females) referred to our institution between April 2020 and September 2021 for non-orthopedic problems. Patients were screened for normal gait and posture using the visual observation method (VOM) and the Modified Gait Abnormality Rating Scale (GARS-M). In standing standard radiographs, the PO angle was measured as the angle between the horizontal plane and the inter-teardrop line.ResultsPatients' mean age and Body Mass Index (BMI) were 39.7 ± 16.8 and 22.3 ± 3.1, respectively. PO angles did not follow a normal distribution, with a median (IQR) of 2.0° (0.9°—3.1°). According to the Wilcoxon one-sample test, the median PO angle differed significantly from zero (P < 0.001). The PO angle did not differ significantly between males and females (2° vs. 2°, P = 0.46), nor did it correlate significantly with age (P = 0.24). Considering the 95% percentile of PO angles was 5.6°, this range (0°—5.6°) was regarded as a normative value.ConclusionNormative values for PO in the normal healthy population range from 0° to 5.6°, with a median value of 2.0°. The PO angle was independent of age and sex and differed significantly from 0°. Slight pelvic obliquity may be normal, and physicians should not always assume that it is caused by pain, scoliosis, or weakness of the abductors.Level of evidenceIII.

Electroskip auditory biofeedback in a patient with Parkinson disease: a case report.

The purpose of this case study was to observe the effects of a rehabilitation program with an audio-biofeedback technology device called Electroskip in a patient with Parkinson disease. The patient was a 61-year-old man with moderate Parkinson disease (Hoehn and Yahr Parkinson’s scale stage III) and dementia who had progressive episodes of freezing of gait. The patient also had a history of recent falls. The patient completed a 6-week rehabilitation program focused on functional tasks, balance and gait training while using Electroskip technology, which is a wireless, wearable device that sends a discrete real-time generative audio-biofeedback signal when the user steps on either the heel or toe force sensors positioned under the innersoles. The outcome measures included the Timed Up and Go test, the modified Gait Abnormality Rating Scale, the modified Parkinson’s Activity Scale, and the Freezing of Gait Questionnaire. The patient completed 17 of the 18 scheduled training sessions and all testing sessions; no adverse events occurred during the rehabilitation program and high satisfaction levels were reported by the patient and family after completion of the 6-week rehabilitation program. Clinically significant improvements were seen in all measures at 6 weeks. The results of this report suggest that a rehabilitation program focused on functional tasks, balance, and gait training using the Electroskip technology may be beneficial for improving gait and balance in a patient with moderate Parkinson disease. Future work is needed to determine the effectiveness of Electroskip technology by means of randomized controlled trials.

An observational treatment-based gait pattern classification method for targeting interventions for older adult males with mobility problems: Validity based on movement control and biomechanical factors

BackgroundA reliable and valid observational gait assessment intended to guide clinical intervention for gait deficits in older adults has not been proposed. A quick gait classification method which tailors clinical management for different patterns of gait dysfunction may be useful for clinicians with limited access to apply computer-assisted gait analyses. Research QuestionThis work aims to establish reliability and validity of the Treatment-Based Gait Pattern Classification (TBGPC) that can be used to quickly identify and classify mobility problems of older males, and possibly target interventions for specific gait deficits in clinical settings. MethodVideotapes of 116 older male veterans referred for mobility problems were analyzed in this cross-sectional study. The TBGPC defined by movement control (consistent, inconsistent) and postural biomechanical factors (usual, flexed, extended, crouched) was validated by comparing means of individual items of the Modified Gait Abnormality Rating Scale (GARS-M) across groups. ResultsKappas for interrater reliability of the TBGPC movement control and biomechanical components were 0.59 and 0.75, respectively; for intrarater reliability, 0.82 and 0.72, respectively. Both movement control and biomechanical components were validated. All GARS-M items were different between older males with consistent and inconsistent gait. Within the consistent and inconsistent group, hip ROM was one of the most differentiating GARS-M item between older males with usual and flexed gait and flexed and crouched group. Total GARS-M score and guardedness were two differentiating factors between the usual and crouched group. SignificanceGait patterns of older males were reliably recognized and validated by mean differences in abnormal characteristics of gait across patterns. The TBGPC may be useful to quickly identify and classify mobility problems of older males and to guide clinical intervention.

Feasibility of Neurorehabilitation Using a Hybrid Assistive Limb for Patients Who Underwent Spine Surgery.

Recent studies of robotic rehabilitation have demonstrated its efficacy for neurological disorders. However, few studies have used the Hybrid Assistive Limb (HAL) during the early postoperative stage of spine disorders. We aimed to evaluate the safety and efficacy of HAL treatment during the early postoperative period for spine disorder patients. We retrospectively identified patients who underwent spine surgery and who could complete HAL treatment. We evaluated the 10-m walking test (10MWT), the modified Gait Abnormality Rating Scale (GARS-M), Barthel Index (BI), and the walking index for spinal cord injury II (WISCI II) score results before and after robotic rehabilitation. Clinical outcomes were compared after treatment. We included nine patients with various spine problems. After HAL treatment, the speed during the 10MWT significantly improved from 64.1 ± 16.0 to 74.8 ± 10.8 m/min, and the walking cadence decreased from 102.7 ± 17.6 to 92.7 ± 10.9 steps/min. The BI score also improved from 83.3 ± 16.0 to 95.6 ± 5.8, and the WISCI II score improved from 19.7 ± 0.5 to 20.0 ± 0.0. Furthermore, the total GARS-M score improved from 6.0 ± 5.7 to 2.3 ± 3.3. The maximum angles of the trunk swing were improved from 2.2 ± 1.9 to 1.2 ± 0.9 degrees. Neurorehabilitation therapy using HAL for spinal surgery patients was considered feasible following spine surgery.

Comparative Analysis of High-Velocity Versus Low-Velocity Exercise on Outcomes After Total Knee Arthroplasty: A Randomized Clinical Trial.

High-velocity (HV) exercise is defined as performing a concentric muscle contraction as fast as possible, or in 1 second or less. Low-velocity (LV) exercise is defined as using 2 seconds to complete the contraction. A comparison of HV to LV exercise performed by community dwelling older adults indicates that HV exercise produces greater gains in power and scores for the 8-ft up-and-go, 30-seond chair stand, and continuous scale physical function performance tests. The effectiveness of HV strengthening exercises has not been identified for individuals who undergo total knee arthroplasty (TKA). The purpose of this research study was to compare the effects of a 6-week exercise program, using either LV or HV contractions, on functional performance, gait, and pain of individuals who have undergone TKA. Adults aged 60 to 89 years with a mean (standard deviation) age of 71.2 (6.8) years who underwent TKA an average of 15 days prior were randomly assigned to an HV exercise (n = 19) or LV exercise (n = 19) training group. The training program lasted for 12 sessions, over 6 to 7 weeks. The primary outcome was functional performance rated with the 6-Minute Walk Test. Secondary measures were the stair climb test, Timed Up and Go test, gait velocity, gait deviations measured with the Gait Abnormality Rating Scale, and pain via a visual analog scale. A 2×2 mixed model analysis of variance (group × time) was used for all outcomes. Comparison between LV and HV groups for posttest gait velocity and Gait Abnormality Rating Scale used independent t test and Mann-Whitney U test, respectively. At baseline no differences between groups were noted for sex, age, and height. The LV group weighed more and had more comorbid conditions. Spearman's ρ demonstrated that the greater comorbidities of the LV group correlated with a slower stair climb test at baseline. At posttest both groups exhibited significantly improved scores for all outcome measurements except the visual analog scale for pain. The HV group, but not the LV group, reported a significant decrease in pain at the end of the 6-week training program. Both HV and LV progressive exercises equally improve functional performance. Only the HV group reported significantly decreased pain at posttest.

The reliability, validity and correlation of two observational gait scales assessed by video tape for Chinese subjects with hemiplegia.

To test the reliability of the Wisconsin Gait Scale (WGS) and the Gait Abnormality Rating Scale (GARS) for hemiplegic Chinese subjects, as well as to establish the concurrent validity of these two scales with clinical measurements. [Subjects] Twenty hemiplegic stroke subjects were recruited for this study. [Methods] The subjects walked along a 10-meter walkway and their gait was videotaped from 4 directions. Two physical therapists assessed the subjects’ gait using the aforementioned scales by watching the video tape. The Intraclass Correlation Coefficient (ICC) was calculated for the two physiotherapists’ scores for each category and the total scores to assess the reliability. Concurrent validity was tested by comparing the total scores to subjects’ walking speed, the Fugl-Meyer assessment, the Motricity Index of the lower limb, and the Composite Spasticity Index of the lower limb. [Results] The ICC of WGS was 0.961 for intra-rater reliability, and 0.945 for inter-rater reliability. The ICC of GARS was 0.708 for intra-rater reliability and 0.875 for inter-rater reliability. The correlations of the two scales with walking speed, the Fugl-Meyer assessment and the Motricity Index were statistically significant. [Conclusion] Both the Wisconsin Gait Scale and the Gait Abnormality Rating Scale are reliable and valid protocols for measuring the hemiplegic gait of stroke patients.

Modified Gait Abnormality Rating Scale in Patients with Conversion Disorder: A Reliability and Responsiveness Study

Objective: Patients with conversion disorder have neurologic symptoms such as gait disturbances that are not attributed to an underlying organic cause. The modified gait abnormality rating scale (GARS-M) may be useful for quantifying gait abnormalities in these individuals. The purpose of this study was to examine the reliability and responsiveness of the GARS-M to quantify gait abnormalities in individuals with conversion disorder. Design: The study used a single-group pretest-posttest design. Preand postintervention videos were obtained during 10-m walks. Four examiners independently evaluated gait performance according to the GARS-M criteria. One examiner re-evaluated the videos approximately two months later. Setting: This study was conducted within an outpatient therapy clinic at a large, academic tertiary referral center. Participants: Data from 27 consecutive patients with conversion disorder who completed Mayo Clinic’s multidisciplinary Behavioral Shaping Therapy program were included in the study. Interventions: N/A. Main Outcome Measure(s): Interand intra-rater reliability of scores obtained with the GARS-M were estimated with intraclass correlation coefficients (ICCs). Responsiveness was estimated with the minimum detectable change (MDC). Results: GARS-M scores were quantified with good-to-excellent inter(ICCZ0.878) and intra-rater reliability (ICCZ0.989). The MDC was 2 points; 85% of the patients had improvements in GARS-M scores that exceeded the MDC. Furthermore, GARS-M scores and walking speed measurements were moderately correlated (rZ-0.582, pZ0.004), indicating that the GARS-M has acceptable criterion-related validity. Conclusions: Our findings provide evidence that the GARS-M is scored reliably in patients with conversion disorder. Additionally, it is a responsive andvalid instrument toquantify changes ingait abnormalities in these patients.

A video-based balance measure for people with intellectual disability

Background Many standardised balance measures are unsuitable for people who are unable to comprehend test requirements. We report on the development, administration, interrater reliability, and concurrent validity of a video-based balance measure for people with intellectual disability called the Balance Scale for Persons with Intellectual Disabilities.Method Video recordings of 25 people performing 7 common motor tasks, identified from stakeholder consultation, were made, and rated using standardised scoring criteria. Concurrent validity, assessed against the Tinetti Gait and Balance Instrument and the modified Gait Abnormality Rating Scale (GARS-M), and interrater reliability of the scale was evaluated with 19 physiotherapists.Results Scores suggested no ceiling or floor effects. Excellent interrater reliability (ICC = .9) was demonstrated. Concurrent validity was good against the Tinetti (ρ = .98) and the GARS-M (ρ = −.87). Issues around lighting for video-recording and lack of steps or stairs in the home setting were encountered.Conclusion The new measure may be useful in trials assessing the effectiveness of interventions aimed at improving the balance capabilities of people with intellectual disability.

Evaluation of the Inter-rater Reliability of a Modified Gait Abnormality Rating Scale for Elderly Individuals in Japan Using Video Monitoring

Evaluation of the Inter-rater Reliability of a Modified Gait Abnormality Rating Scale for Elderly Individuals in Japan Using Video Monitoring

Perceived Effort of Walking: Relationship With Gait, Physical Function and Activity, Fear of Falling, and Confidence in Walking in Older Adults With Mobility Limitations

Although clinicians have a number of measures to use to describe walking performance, few, if any, of the measures capture a person's perceived effort in walking. Perceived effort of walking may be a factor in what a person does versus what he or she is able to do. The objective of this study was to examine the relationship of perceived effort of walking with gait, function, activity, fear of falling, and confidence in walking in older adults with mobility limitations. Design This investigation was a cross-sectional, descriptive, relational study. The study took place at a clinical research training center. The participants were 50 older adults (mean age=76.8 years, SD=5.5) with mobility limitations. The measurements used were the Rating of Perceived Exertion (RPE) for walking; gait speed; the Modified Gait Abnormality Rating Scale; energy cost of walking; Late Life Function and Disability Instrument (LLFDI) for total, basic, and advanced lower-extremity function and for disability limitations; activity and restriction subscales of the Survey of Activities and Fear of Falling in the Elderly (SAFFE); activity counts; SAFFE fear subscale; and Gait Efficacy Scale (GES). The relationship of the RPE of walking with gait, function, activity, fear, and confidence was determined by using Spearman rank order coefficients and an analysis of variance (adjusted for age and sex) for mean differences between groups defined by no exertion during walking and some exertion during walking. The RPE was related to confidence in walking (GES, R=-.326, P=.021) and activity (activity counts, R=.295, P=.044). The RPE groups (no exertion versus some exertion) differed in LLFDI scores for total (57.9 versus 53.2), basic (68.6 versus 61.4), and advanced (49.1 versus 42.6) lower-extremity function; LLFDI scores for disability limitations (74.9 versus 67.5); SAFFE fear subscale scores (0.346 versus 0.643); and GES scores (80.1 versus 67.8) (all P<.05). Limitations The range of RPE scores for the participants studied was narrow. Thus, the real correlations between RPE and gait, physical function, and psychological aspects of walking may be greater than the relationships reported. The perceived effort of walking was associated with physical activity and confidence in walking. Reducing the perceived effort of walking may be an important target of interventions to slow the decline in function of older adults with mobility limitations.

Evaluation of the Inter-rater Reliability of a Modified Gait Abnormality Rating Scale for Elderly Individuals in Japan Using Video Monitoring

Evaluation of the Inter-rater Reliability of a Modified Gait Abnormality Rating Scale for Elderly Individuals in Japan Using Video Monitoring

The interrater reliability of the modified Gait Abnormality Rating Scale for use with people with intellectual disability

Background Researching falls in persons with ID is limited by difficulties in applying standardised balance outcome measures. The modified Gait Abnormality Rating Scale (GARS-M), developed to identify falls risk in older adults, requires only that the participant walks and thus may be a feasible falls research tool to use with people with ID. In the present study, we consider the interrater reliability of the GARS-M.Method Nine people with ID were videotaped walking. These recordings were used by 10 physiotherapists to rate the person's walking on the 7 categories of the GARS-M. The intraclass correlation coefficient (ICC) was calculated for the physiotherapists' scores in each category and the total score; ICC ≥ 0.7 indicating good interrater reliability.Results The ICC was greater than 0.7 in only one category of the GARS-M, but ICC = 0.85 for the total score. Average time to rate one person was 8 minutes.Conclusions The GARS-M is potentially useful for falls prevention research with people with ID.

Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test

The Figure-of-8 Walk Test (F8W) involves straight and curved paths and was designed to represent walking skill in everyday life. The purposes of this study were to validate the measure in older adults with walking difficulties and to explore correlates of the curved-path walking measure not represented by a straight-path walking measure. Fifty-one community-dwelling older adults with mobility disability participated in 2 baseline visits as part of an intervention study. The F8W time, steps, and smoothness and measures of gait (gait speed, modified Gait Abnormality Rating Scale [GARS-M]), physical function (Late Life Function and Disabilities Index [LLFDI], Survey of Activities and Fear of Falling in the Elderly [SAFFE], Gait Efficacy Scale [GES], Physical Performance Test [PPT], and fall history), and movement control and planning (gait variability, Trail Making Test B [Trails B]) were recorded in each test session. Bivariate correlations for the F8W with each variable were conducted to examine concurrent and construct validity. Adjusted linear regression analyses were performed to explore the variance in mobility explained by F8W independent of gait speed. Figure-of-8 Walk Test time correlated with gait (gait speed, r=-.570; GARS-M, r=.281), physical function (LLFDI function, r=-.469; SAFFE restriction subscale, r=.370; PPT, r=-.353), confidence in walking (GES, r=-.468), and movement control (step length coefficient of variation, r=.279; step width coefficient of variation, r=-.277; Trails B, r=.351). Figure-of-8 Walk Test steps correlated with step width variability (r=-.339) and was related to fear of falling (t=-2.50). All correlations were significant (P<.05). This pilot study had a small sample size, and further research is needed. The F8W is a valid measure of walking skill among older adults with mobility disability and may provide information complementary to gait speed.

Long-term Outcomes Following Anterior Tibialis Tendon Reconstruction with Hamstring Autograft in a Series of 3 Cases

Ruptures of the anterior tibialis tendon are uncommon, and there is a paucity of information regarding long-term ankle function following surgical reconstruction using hamstring autograft. In this case series, examinations were performed on 3 individuals who underwent anterior tibialis tendon reconstruction with hamstring autograft performed by the same surgeon. Two subjects were examined 8 years after reconstructive surgery, and 1 was examined at 5 years postoperative. Muscle strength and range of motion of subjects' ankles bilaterally were assessed using standard measures. The Tinetti Performance Oriented Mobility Assessment and the modified Gait Abnormality Rating Scale were used to assess gait and balance. The information gathered from these 3 cases indicates that tibialis anterior strength and ankle range of motion can be maintained or improved years after anterior tibialis reconstruction with hamstring autograft, and these individuals have a low risk of falling long after the repair has healed. 4.

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

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.

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

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.

Assessing recurrent fall risk of community-dwelling, frail older veterans using specific tests of mobility and the physical performance test of function.

The purpose of this prospective cohort study was to determine if older individuals at risk for recurrent falls are best identified by mobility or functional assessments. Eighty-four community-dwelling, frail male veterans, mean age of 75.5 years (SD=7.33), participated. The history of recurrent falls was determined by self or proxy report in a clinical interview. Mobility assessments included the Modified Gait Abnormality Rating Scale (GARS-M), stride length, and walking velocity; functional performance was determined using the Physical Performance Test (PPT). The clinical usefulness of the measures was described by determining the sensitivity and specificity of each measure using the history of recurrent falls as a standard. Stepwise logistic regression analysis of the data indicated that the GARS-M (p < .01) and the PPT (p < .01) were the most important predictors of recurrent fall risk. The sensitivity and specificity of the measures used were: GARS-M, 62.3% and 87.1%; PPT, 79.3% and 71.0%; walking speed, 71.7% and 74.2%; and stride length, 63.2% and 77.4%. Together the GARS-M and PPT demonstrated the highest sensitivity of 90.6% and the highest specificity of 87. 1% based on a subject testing positive on at least one test. Used independently and in combination, the GARS-M and the PPT were clinically useful measures in screening for older individuals at risk for recurrent falls.

The modified Gait Abnormality Rating Scale for recognizing the risk of recurrent falls in community-dwelling elderly adults.

The purpose of this study was to determine the reliability and validity of measurements obtained with a seven-item modified version of the Gait Abnormality Rating Scale (GARS-M), an assessment of gait designed to predict risk of falling among community-dwelling, frail older persons. Fifty-two community-dwelling, frail older persons, with a mean age of 74.8 years (SD = 6.75), participated. A history of falls was determined from self-report or by proxy report. The GARS-M was scored from videotapes of subjects walking at self-selected paces. Gait characteristics were recorded during a timed walk on a 6-m brown-paper walkway. Scores obtained by three raters for 23 subjects demonstrated moderate to substantial intrarater and interrater reliability. Concurrent validity, as assessed by Spearman rank-order correlation coefficients, was demonstrated for the relationship between GARS-M scores and stride length (r = -.754) and for the relationship between GARS-M scores and walking speed (r = -.679). Mean GARS-M scores distinguished between frail older persons with and without a history of recurrent falls (mean GARS-M scores of 9.0 and 3.8, respectively). The GARS-M is a reliable and valid measure for documenting gait features associated with an increased risk of falling among community-dwelling, frail older persons and may provide a clinically useful alternative to established quantitative gait-assessment methods.

Gait Assessment in the Elderly: A Gait Abnormality Rating Scale and Its Relation to Falls

We evaluated the gait of 49 nursing home residents (27 of whom had a history of recent falls), and 22 controls. Measures consisted of stride length and walking speed, as well as a videotape-based analysis of 16 facets of gait. The study demonstrates that stride length, walking speed, and the assessment of videotaped gait correlated well with each other and were significantly impaired in fallers compared to controls. Arm swing amplitude, upper-lower extremity synchrony, and guardedness of gait were most impaired in fallers. Although subjects who fell were more often demented than controls, it is likely that this represents a selection bias in nursing homes. Visual rating of gait features in the nursing home population is a simple and useful alternative to established methods of gait analysis.