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

      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.
      A full review of the FGA and reviews of over 300 other instruments can be found at www.rehabmeasures.org.
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      • 1.
        Wrisley D, Walker M, Echternach JL, Strasnick B. Reliability of the Dynamic Gait Index in people with vestibular disorders. Arch Phys Med Rehabil 2003;84:1528-33.
      • 2.
        Wrisley DM, Marchetti GF, Kuharsky DK, Whitney SL. Reliability, internal consistency, and validity of data obtained with the Functional Gait Assessment. Phys Ther 2004;84:906-18.
      • 3.
        Walker M, Austin A, Banke GM, et al. Reference group data for the Functional Gait Assessment. Phys Ther 2007;87:1468-77.
      • 4.
        Wrisley DM, Kumar NA. Functional Gait Assessment: concurrent, discriminative, and predictive validity in community-dwelling older adults. Phys Ther 2010;90:761-73.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary’s publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors’ employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, the United States Department of Education, or the Retirement Research Foundation. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (grant no. H133B090024) and the Retirement Research Foundation (grant no. 2011-027).