Expanding the Scoring System for the Dynamic Gait Index.

Background. The Dynamic Gait Index (DGI) measures the capacity to adapt gait to complex tasks. The current scoring system combining gait pattern (GP) and level of assistance (LOA) lacks clarity, and the test has a limited range of measurement. Objective. This study developed a new scoring system bas...

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Publicado en:Physical Therapy Vol. 93; no. 11; pp. 1493 - 1507
Autores principales: Shumway-Cook, Anne, Taylor, Catherine S., Matsuda, Patricia Noritake, Studer, Michael T., Whetten, Brady K.
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA Nov2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Expanding the Scoring System for the Dynamic Gait Index.
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          Shumway-Cook, Anne
          Taylor, Catherine S.
          Matsuda, Patricia Noritake
          Studer, Michael T.
          Whetten, Brady K.
        affil: Department of Rehabilitation Medicine, Division of Physical Therapy, University of Washington, 1959 NE Pacific St, Box 356490, Seattle, WA 98195 (USA)
      sug:
        subj:
          Instrument Validation
          Clinical Assessment Tools Evaluation
          Gait Analysis
          Gait Disorders, Neurologic Diagnosis
          Psychometrics
          Clinical Assessment Tools
          Scales
          Cross Sectional Studies
          Descriptive Research
          kappa Statistic
          Internal Consistency
          Coefficient alpha
          Rasch Analysis
          Interrater Reliability
          T-Tests
          Test-Retest Reliability
          Effect Size
          Sample Size
          Convenience Sample
          Factor Analysis
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Female
          Male
          Human
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Background. The Dynamic Gait Index (DGI) measures the capacity to adapt gait to complex tasks. The current scoring system combining gait pattern (GP) and level of assistance (LOA) lacks clarity, and the test has a limited range of measurement. Objective. This study developed a new scoring system based on 3 facets of performance (LOA, GP, and time) and examined the psychometric properties of the modified DGI (mDGI). Design. A cross-sectional, descriptive study was conducted. Methods. Nine hundred ninety-five participants (855 patients with neurologic pathology and mobility impairments [MI group] and 140 patients without neurological impairment [control group]) were tested. Interrater reliability was calculated using kappa coefficients. Internal consistency was computed using the Cronbach alpha coefficient. Factor analysis and Rasch analysis investigated unidimensionality and range of difficulty. Internal validity was determined by comparing groups using multiple t tests. Minimal detectable change (MDC) was calculated for total score and 3 facet scores using the reliability estimate for the alpha coefficients. Results. Interrater agreement was strong, with kappa coefficients ranging from 90% to 98% for time scores, 59% to 88% for GP scores, and 84% to 100% for LOA scores. Test-retest correlations (r) for time, GP, and LOA were .91, .91, and .87, respectively. Three factors (time, LOA, GP) had eigenvalues greater than 1.3 and explained 79% of the variance in scores. All group differences were significant, with moderate to large effect sizes. The 95% minimal detectable change (MDC95) was 4 for the mDGI total score, 2 for the time and GP total scores, and 1 for the LOA total score. Limitations. The limitations included uneven sample sizes in the 2 groups. The MI group were patients receiving physical therapy; therefore, they may not be representative of this population. Conclusions. The mDGI, with its expanded scoring system, improves the range, discrimination, and facets of measurement related to walking function. The strength of the psychometric properties of the mDGI warrants its adoption for both clinical and research purposes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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