- Performed with a marked distance of 20 feet
- Can be performed with or without an assistive device
- Scores are based on a 4-point scale:
- 3 = No gait dysfunction
- 2 = Minimal impairment
- 1 = Moderate impairment
- 0 = Severe impairment
- Highest possible score is 24 points. Tasks include:
- Steady state walking
- Walking with changing speeds
- Walking with head turns both horizontally and vertically
- Walking while stepping over and around obstacles
- Pivoting while walking
- Stair climbing
- Shoe box
- Two obstacles (must be same size)
- Stairs
- 20 foot (6.1 meter) pathway
- Brain injury
- Geriatric
- Multiple Sclerosis
- Parkinson's disease
- Stroke
- Vestibular disorders
Community Dwelling Elderly:
(Romero et al 2011; n = 42; mean age = 75.6 (range 59-88) years, Community Dwelling Elderly)
- SEM = 1.04 points
Multiple Sclerosis:
(Cattaneo et al, 2007; n = 25, mean age = 41.7 (12.5) years; mean time since onset = 8.7 (8.8) years; Italian sample, MS)
- SEM inter-rater reliability = 1.51 points
- SEM intra-rater relibaility = 2.00 points
Stroke:
(Jonsdottir & Cattaneo, 2007, n = 25; mean age = 61.6 (13.1) years; mean time since stroke = 4.2 (7.5) years, range 0.5-35.3 years; Italian sample, Chronic Stroke)
- SEM for inter-rater reliability = 0.97 points
- SEM for interrater reliability = 0.94 points
Peripheral Vestibular Disorders:
(Calculated from Hall & Herdman, 2006; n = 16; age 51.8 (13.4) years, diagnosis of unilateral or bilateral vestibular hypofunction)
- SEM calculated = 2.8 points
Chronic Stroke:
(calculated from Jonsdottir and Cattaneo, 2007)
- MDC (calculated from SEM) = 2.6 points
Community Dwelling Elderly:
(Romero et al, 2011, Community Dwelling Elderly)
- MDC = 2.9 points
Multiple Sclerosis:
(Cattaneo et al, 2007, MS)
- MDC (Calculated from SEM) = 4.19-5.54
Parkinson's Disease:
(Huang et al, 2011, n = 72; mean age = 67.5 (11.6); range of disease duration = 2 months-15 years; Hoehn-Yahr range I-III(Stage I = 17, II = 33, III = 22), Taiwanese sample)
- MDC = 2.9 points
- MDC% = 13.3%
Stroke:
(Lin et al, 2010; n = 45; mean age = 60.7 (12.2) years; median time since stroke = 9 months (range 3 to 36 months); Taiwanese sample, Stroke)
- MDC = 4 points
- Percent change = 16.6%
Vestibular Disorders:
(Calculated from Hall & Herdman, 2006, Peripheral Vestibular Disorders)
- MDC calculated = 3.2 points
Community-dwelling Older adults:
(Pardasaney et al, 2012; n = 111 aged 65 or older; mean age 75.9 + 7 years, 68.5% female)
- 1.90 points for total sample
- 1.80 for subjects with DGI scores < 21/24
- 0.60 for subjects with DGI scores > 21/24
Community Dwelling Elderly:
(Shumway-Cook et al,1997; n = 44; age > 65, Community Dwelling Elderly)
- < 19 indicative of increased fall risks (Sensitivity 59%, Specificity 64%)
Community-Dwelling Older Adults:
(Wrisley and Kumar, 2010; n = 35, mean age 72.9 + 7.8 years followed for prospective falls)
- < 19 indicates increased risk of falls (Sensitivity 67%, specificity 86%)
Vestibular Disorders:
(Whitney et al, 2000; n = 247, age 14-95 years, mean 62.4 years, central and peripheral vestibular dysfunction)
- Subjects with scores of < 19/24 are 2.58 times more like to have reported a fall in the previous 6 months than subjects with scores above 19
Multiple Sclerosis:
(Cattaneo et al, 2006; n = 51; relapsing-remitting or secondary progressive MS; mean age 45.3 (18.1) years; mean time since onset 15.6 (7.6) years, MS)
- < 12 indicative of fall-risk (Sensitivity 45%, Specificity 80%)
Parkinson's Disease:
(Dibble et al, 2008; total n = 70, mean age = 73.9(6.45), mean J&Y=2.5 (range 1-4), 36 fallers & 34 nonfallers; fallers (n = 36, mean age = 75.25(5.15)), mean duration of PD = 8.32 (8.67), mean modified H&Y=2.5, 28 male/8 female); and non-fallers (n = 34, mean age = 72.50(7.4)), mean duration of PD = 6.49(4.93), mean modified H&Y = 2.0
- Adequate discriminative ability between fallers and non-fallers based on cutoff score < 19 (sensitivity = 0.64, specificity = 0.85, +LR = 4.26, -LR = 0.42)
(Landers et al 2008, JNPT) (Total n = 49, mean age = 70.9(8.9) yrs, 20 female/29 male; 25 of participants were fallers (mean duration of diagnosis = 75.6(66.9) months, mean UPDRS = 41.8(9.6), mean H&Y = 3.0(0.55)) and 24 participants were non-fallers (mean age = 70.1(6.9) yrs, mean duration since Dx = 45.4(36.9) months, mean UPDRS = 26.8(10.0), mean H&Y = 2.1(0.61)}
- Adequate discriminative ability between fallers and nonfallers using cut score = 18.5 (AUC = 0.758, Sensitivity = 0.68, Specificity = 0.708, +LR = 2.33, -LR = 0.45; post-test probability = 0.708, Odds ratio 5.20(1.54-17.56) 95%CI)
(Vereeck et al, 2008; n = 318; mean age = 49.2(18.7), Healthy Adults)
| Decade | Mean | SD | 5th Percentile | Range |
| 3 | 24.0 | 0.2 | 24 | 23-24 |
| 4 | 24.0 | 0.2 | 24 | 23-24 |
| 5 | 23.9 | 0.4 | 23 | 22-24 |
| 6 | 23.9 | 0.4 | 23 | 22-24 |
| 7 | 23.2 | 0.9 | 21 | 21-24 |
| 8 | 22.0 | 2.0 | 18 | 13-24 |
Stroke:
(Lin et al, 2010, Acute and Chronic Stroke)
| Median Scores for DGI: | |||
| 1 week | 2 months | 5 months | |
| Median score | 13 | 14 | 14 |
| Range: 1st to 3rd quartile | 10-18 | 10-20 | 11-20 |
(Hwang et al, 2010; n = 11; mean age = 48.09 (5.85) years; mean time post stroke = 24.36 (10.84) months, Chronic Hemiparetic Stroke)
| Mean DGI Score: | ||
| | Mean | SD |
| Pretest | 10.64 | 2.01 |
| Posttest | 11.64 | 3.36 |
Parkinson's Disease:
(Cakit et al, 2007; n = 31; mean age 71.8 (6.4) years, Parkinson's Disease)
| Mean DGI Score: | ||
| | Mean | SD |
| Baseline | 16.3 | 5.2 |
| Outcome | 16.54 | 3.35 |
Multiple Sclerosis:
(Cattaneo et al, 2007, Multiple Sclerosis)
- Excellent test-retest reliability (ICC = 0.85)
Parkinson's Disease:
(Huang et al, 2010, Parkinson's Disease)
- Excellent test-retest reliability (ICC = 0.84)
(Kadivar et al, 2011) (n = 16, age range 59-81 yrs, 5 female/11 males, H&Y stage (range 2-4))
- Excellent test retest reliability (ICC > 0.99)
Stroke:
(Lin et al, 2010; tested in separate sample of 48 patients with chronic stroke; mean age = 54.9 (10.2) years, Acute and Chronic Stroke)
- Excellent test-retest reliability (ICC > 0.94; 0.91-0.97)
(Jonsdottir & Cattaneo, 2007; n = 25 mean age = 61.6 (13.1) years, Chronic Stroke)
- Excellent total score test re-test reliability (ICC = 0.96)
- Individual items varied from 0.56 (gait and pivot turns) to 1.00 (stair climbing)
Vestibular Population:
(Hall et al, 2006; n = 16 patients with vestibular disorders; mean age = 51.8 (13.4) years)
- Excellent test-retest reliability (ICC = 0.86 (total score) (individual items ranged from 0.04-0.90))
Community Dwelling Older Adults with Baseline Impairment:
(Jønsson et al, 2011; n = 24 (Hospital), mean age = 79.4 (6.8) years; n = 26 (outpatient rehabilitation), mean age = 76.8 (6.4) years; assessed at a 1.5 hour interval, rated by 3 PT's at each site; Danish language sample, Community Dwelling Older Adults)
Hospital:
- Excellent intrarater reliability (ICC = 0.90)
- Excellent interrater reliability (ICC = 0.92)
Outpatient Rehabilitation:
- Excellent intrarater reliability (ICC = 0.89)
- Excellent interrater reliability (ICC = 0.82)
Multiple Sclerosis:
(McConvey and Bennett, 2005, MS)
- Excellent interrater reliability (ICC = 0.983)
- Range from r = 0.910-0.976 for individual test terms
- Excellent intrarater reliability (ICC = 0.760-0.98)
Stroke:
(Jonsdottir & Cattaneo, 2007, Chronic Stroke)
- Excellent interrater reliability (ICC = 0.96)
Vestibular:
(Wrisley et al, 2003; n = 30, age range 27-88 years referred for vestibular rehabilitation)
- Adequate inter-rater reliability (k = 0.64)
Brain Injury:
(Medley, A. et al, 2006; n = 26; mean age = 41.9 (12.4) years, Brain Injury)
- Found that a person who scores 19 out of 24 points on the DGI has a 28% probability of falling. A person who scores 24 out of 24 points would have a 6% chance of falling and a person who scores 0 out of 24 points would have a 100% change of falling
(McConvey and Bennet, 2005)
- Excellent concurrent validity with 6.1m timed walked test (r = -0.81)
- Excellent, Balance Self-Perceptions Test and DGI (r = 0.76)
- Excellent, Berg Balance Scale and DGI (r = 0.67)
- Adequate, Assistive Devices History and DGI (r = -0.44)
- Adequate, History of imbalance and DGI (r = -0.46)
- Excellent concurrent validity with the Berg Balance Scale, TUG, DI, and ABC respectively (Spearman coefficient = 0.78, -0.80, -0.54)
- Poor concurrent validity with the DHI (Spearman coefficient = -0.39)
Parkinson's Disease:
(Cakit et al. 2007; n = 31, mean age = 71.8(6.4), mean duration of PD = 5.58(2.9), mean UPDRS motor subscale = 18.4(9.32))
- Adequate concurrent validity with UPDRS-motor subscale scores (r = -0.567, p < 0.001)
- Excellent correlation with history of falls in PD (r = 0.643, p < 0.01)
- Excellent concurrent validity with Berg Balance Scale (r = 0.83)
- Excellent concurrent validity with the ABC (r = 0.68)
(Lin et al, 2010, Acute and Chronic Stroke)
- Excellent concurrent validity amongst DGI, 4 itme DGI, and FGA (r > 0.91)
- Berg Balance Scale and DGI scores agreed 63% of the time on fall risk criteria
- DGI appears to be more sensitive than the Berg Balance Scale in identifying fall risk in patients with vestibular disorders
(Whitney et al. 2000 (n = 30 patients (aged 27 to 88) diagnosed with vestibular disorders, Vestibular Population)
- Excellent concurrent validity (r = 0.71) between the DGI and the Berg Balance Scale
| Acute and Chronic Stroke: (Lin et al, 2010)
Multiple Sclerosis: (Cattaneo et al, 2006)
Parkinson's Disease: (Landers et al, 2008)
|
| (Dibble et al, 2006; n = 45 with idiopathic PD, mean age = 69.94(11.8), mean duration of PD = 7.43(5.62) years, mean H&Y level = 2.6(0.66); fallers n = 25 and non-fallers n = 20; faller subgroup characteristics (mean age = 73.25(8.58), mean duration of PD = 9.07(6.13), mean H&Y = 2.95(0.62)); non-faller subgroup characteristics (mean age = 65.91(9.89), mean duration of PD = 5.43(4.25), mean H&Y = 2.17(0.42))
|
- Eash original 4 rating scale categories distinctly identified subjects at different ability levels
- Clear difficulty hierarchical order
- 8 items on the DGI appear to represent a single construct
Community-dwelling older adults:
(Pardasaney et al, 2012)
- No floor effect
- Poor ceiling effect
- 40% at maximum score at baseline
- 70% at maximum score after intervention
-
Multiple Sclerosis:
(Cattaneo et al, 2006, MS)
- Adequate ceiling effects (7.8%)
Stroke:
(Lin et al, 2010, Acute and Chronic Stroke)
- Excellent indicates minimal floor effects
- Adequate indicates relatively little ceiling effects
| Floor and Ceiling Effects: | ||
| Time Point | Floor Effect % | Ceiling Effect % |
| 1st week of PT | 2.2 | 4.4 |
| 2 months after PT | 0 | 10.3 |
| 5 months after PT | 0 | 11.4 |
Community-dwelling older adults:
(Pardasaney et al, 2012)
- Poor responsiveness
- Effect size 0.27
- Standardized response mean 0.45
- Only people in the lower balance subgroups demonstrated change scores > MCID
-
Multiple Sclerosis:
(Cattaneo et al, 2006, MS)
- Scores of less than 12 discriminated between fallers and non fallers, however, Cattaneo (2006) reported that the BBS and DGI measures were not as good at discriminating between fallers and non-fallers compared to the Equiscale Test.
Parkinson's Disease:
(Cakit et al, 2007)
- Was moderately responsive to change (mean change = 4.72 SD = 0.88) in training group following locomotor treadmill training intervention compared to control group (p < 0.05)
(Kadivar et al, 2011)
- Moderate responsiveness of DGI scores to cued step training with significant differences between the cued and noncued groups (effect size in cued RAS training group = 1.77, in non-cued group = 1.05)
(Landers et al, 2008)
- Sensitivity = 0.680
- Specificity = 0.708
Stroke:
(Lin et al, 2010, Acute and Chronic Stroke)
- Moderate responsiveness in depicting change at 2 months and 5 months after therapy (effect size 0.56, 0.62 respectively)
- Although psychometrics have not been evaluated in SCI population, this measure has been used to assess dynamic balance in 2 SCI studies (Fritz et al, 2011 & Day et al, 2012)
- FGA shows less ceiling effect and is recommended over DGI is stroke population (Lin et al, 2010)
- The DGI has a ceiling effect in people with vestibular dysfunction. (Wrisley 2003)
Dynamic Gait Index translations:
Spanish (p5-7):
http://ift.tt/28L18ks
Arabic: The Arabic version of the DGI can be requested for free from alia.alghwiri@gmail.com
These translations, and links to them, are subject to the Terms and Conditions of Use of the Rehab Measures Database. RIC is not responsible for and does not endorse the content, products or services of any third-party website, and does not make any representations regarding its quality, content or accuracy. If you would like to contribute a language translation to the RMD, please contact us at rehabmeasures@ric.org.
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