Functional Gait Assessment

What is a Functional Gait Assessment (FGA)?

The Functional Gait Assessment (FGA) is a specialized tool designed for healthcare practitioners to assess postural stability and classify fall risk in community-dwelling older adults. Developed as an extension of the Dynamic Gait Index, the FGA comprehensively evaluates an individual's ability to perform various walking tasks, making it a valuable instrument in physical therapy.

One key aspect of the FGA is its focus on dynamic tasks, emphasizing the evaluation of functional gait under conditions that mimic real-world challenges. This includes assessing the individual's ability to change walking speed smoothly, navigate obstacles, and execute turns. Such tasks are crucial for identifying prospective falls, especially in older adults who may face difficulties in adapting to changes in their environment.

To evaluate vestibular function, the assessment incorporates various head movements, including vertical and horizontal head turns. This is particularly relevant in identifying gait deviations related to vestibular disorders, which may go unnoticed during a traditional gait assessment. A smooth path and minimal deviations characterize a normal gait pattern, whereas abnormal gait patterns can indicate an increased fall risk even with only mild deviations.

The FGA has demonstrated high predictive validity in classifying fall risk and predicting unexplained falls. It has proven reliable and valid, with internal consistency and concurrent validity established through reference group data. By systematically analyzing gait velocity, changes in gait speed, and the ability to walk at normal and slower speeds, the FGA provides healthcare professionals with a comprehensive understanding of an individual's gait function.

Furthermore, the FGA has practical implications for identifying prospective falls, allowing healthcare professionals to implement targeted interventions to mitigate fall risk. It complements other commonly used tools, such as the Berg Balance Scale and monthly fall calendars, providing a holistic approach to fall risk assessment in older adults.

Those who are familiar with the DGI may find that the following types of gait have been retained:

• Gait level surface
• Change in gait speed
• Gait with horizontal head turns
• Gait with vertical head turns
• Gait and pivot turn
• Stairs

As for the rest of the test, aside from changes in instructions in some of the types of gait mentioned above, additional tests are added to aid in identifying and even diagnosing vestibular orders. They are as follows:

• Step over obstacle
• Gait with a narrow base of support
• Gait with eyes closed
• Ambulating backwards

The changes were made for two reasons. One, to decrease the ceiling effect of the DGI, and two, to improve reliability.

Equipment, scoring, interpretation, and identification of fall risk and challenges clients may face beyond the test are similar to the DGI. For a summary of these, see below:

• FGA still uses shoeboxes, stairs, a marked walkway, and a stopwatch.
• It also uses an ordinal scale from 0 to 3, with 3 being the highest and 0 being the lowest.
• Scoring still relies on the rater's understanding of descriptions and observational skills.
• At the end of the test, the rater must identify the client's postural stability and balance challenges.

How Does this Functional Gait Assessment PDF work?

The Functional Gait Assessment (FGA) PDF is a systematic and comprehensive tool for healthcare professionals to evaluate gait deviations, particularly in older adults. The step-by-step process outlined in the PDF involves a series of tasks designed to assess different aspects of an individual's gait and postural stability.

Ordinal scale introduction

The PDF likely begins with an introduction to the ordinal scale used for scoring, emphasizing the importance of systematic evaluation. Healthcare professionals are instructed to use this scale to categorize and score specific components of the individual's gait performance.

Beginning the assessment

Individuals are instructed to begin walking at their normal pace. This establishes a baseline for their typical gait pattern, allowing healthcare professionals to observe and analyze potential deviations from the norm.

Walking straight

The PDF guides individuals to walk straight for a designated distance. This task assesses maintaining a normal gait pattern without deviations or imbalance, providing valuable insights into overall gait stability.

Walking backward

Another component involves walking backward, evaluating the individual's ability to navigate in reverse. This task provides insights into dynamic balance, coordination, and the presence of gait deviations in an unconventional direction.

Gait with assistive device

If applicable, the assessment considers walking with an assistive device. This accounts for individuals who may rely on aids like canes or walkers, providing a more accurate representation of their functional gait in daily life.

Turning and pivoting

The PDF likely includes instructions for turning and pivoting during walking. This assesses the agility and balance required for changing directions, which is crucial for understanding an individual's capacity to navigate real-world environments.

Head turns and eyes closed

Tasks involving head turns and walking with eyes closed assess vestibular function and proprioception. These challenges help identify potential gait deviations under altered sensory conditions, enhancing the assessment's sensitivity.

Obstacle negotiation

Individuals may encounter obstacles during the assessment, requiring them to step over objects. This evaluates the ability to adapt gait to environmental challenges, offering insights into dynamic balance control.

Narrow base of support

The PDF likely includes a task where individuals walk with a narrow base of support, emphasizing heel-to-toe alignment. This assesses balance and stability under challenging conditions, reflecting real-world scenarios.

Scoring and interpretation

The healthcare professional uses the ordinal scale to score each assessment component. The cumulative score quantitatively measures the individual's gait performance, identifying specific areas of concern and informing targeted interventions.

Scoring

Functional Gait Assessment, or FGA, is similar to dynamic gait index scoring. You observe your client and check the score based on how fast, accurately, and independently they follow instructions. The Functional Gait Assessment (FGA) template scoring is based on an ordinal scale, providing a systematic way for healthcare professionals to evaluate an individual's gait performance. The template assigns scores ranging from 0 to 3 for different components, with higher scores indicating better gait function.

Typically, scoring goes as follows:

• You give them a three (3) if they can follow instructions quickly, accurately, and without assistance.
• You give them a zero if (0) they can or refuse to do the movement. 
• You give them two (2) or one (1) depending on how they compensate to accomplish the task. Refer to the template for the specific description differences between the two

For example, in the Gait Level Surface section, a score of 3 is given if the individual walks 20 feet without aids at a good speed and with a normal gait pattern, demonstrating no evidence of imbalance. On the other hand, a score of 0 suggests severe impairment, where the person cannot walk the distance without assistance, displaying severe gait deviations or imbalance.

In the Change in Gait Speed section, a score of 3 is awarded if the individual can smoothly change walking speed without losing balance or gait deviation. Conversely, a score of 0 is given for severe impairment, indicating the inability to change speeds or experiencing a loss of balance.

Similar scoring applies to other sections, such as Gait with Horizontal Head Turns, Gait with Vertical Head Turns, and Steps, where the individual's ability to perform tasks with minimal disruptions to the gait path is assessed.

The scoring system is integral in providing a quantitative measure of gait function, allowing healthcare professionals to identify specific areas of impairment. Using an ordinal scale simplifies the interpretation, making it an effective tool for evaluating gait deviations in older adults. The scores obtained from each section can be totaled to provide an overall assessment of an individual's functional gait, aiding in classifying fall risk and informing targeted interventions.

Functional Gait Assessment Example (Sample)

Check out this sample of a completed Functional Gait Assessment (FGA) to understand how to score and interpret the test scores. 

The Functional Gait Assessment (FGA) PDF template is a structured tool for healthcare professionals to assess gait deviations in older adults. Using an ordinal scale, individuals begin walking at their normal pace, with evaluations for walking straight, backward, and negotiating obstacles. The template incorporates specific tasks, such as turning and pivoting, assessing gait with head turns, and walking with eyes closed. It also considers the use of assistive devices and aligns with the Berg Balance Scale, providing a comprehensive evaluation of gait performance for effective intervention planning in older adults.

Download this Functional Gait Assessment Example (Sample) here:

When to use this Gait Assessment?

Healthcare practitioners, particularly those in physical therapy and fall prevention, can strategically employ the Functional Gait Assessment (FGA) template in various scenarios:

Fall risk assessment

• Use the FGA to assess gait path and speed to classify fall risk in older adults.
• Identify individuals with abnormal gait patterns, significant gait deviations, or slower walking speeds, which may contribute to a higher risk of falls.

Post-rehabilitation evaluation

• Implement the FGA in physical therapy settings to evaluate patients post-rehabilitation.
• Assess the patient's ability to walk with a smooth gait path, ensuring they can navigate at normal speeds without significant deviations.

Unexplained falls investigation:

• Utilize the FGA to investigate unexplained falls by identifying subtle gait deviations that may contribute to falling.
• Assess the individual's gait at slower speeds and observe for only minor adjustments, as these factors may play a role in falls.

Monitoring gait changes

• Regularly employ the FGA to monitor changes in gait over time, utilizing the monthly fall calendar for concurrent validity.
• Look for trends in gait deviations or speed variations indicating deteriorating stability.

Predictive validity for future falls:

• Leverage the FGA's predictive validity to identify individuals at risk of future falls.
• Evaluate individuals who demonstrate mild gait deviations or abnormal gait patterns, as these may serve as predictors for prospective falls.

Assistive device optimization

• Assess the effectiveness of assistive devices in maintaining a smooth gait path.
• Use the FGA to identify individuals who may require only minor adjustments while using assistive devices, ensuring optimal functionality.

Internal Consistency and Reliability

• Employ the FGA for its internal consistency to ensure reliable and consistent data are obtained.
• Regularly use the template to maintain consistency in gait assessments and track changes in gait patterns.

The FGA is a valuable resource for healthcare practitioners dealing with gait-related assessments. It aids in fall risk classification, post-rehabilitation evaluation, investigating unexplained falls, monitoring gait changes over time, predicting future falls, optimizing assistive device use, and ensuring internal consistency in data collection. Its focus on gait path, speed, and deviations makes it a versatile tool for a range of professionals working to enhance their patient's functional mobility and stability.

Benefits of free Functional Gait Assessment?

Classifying fall risk:

The Functional Gait Assessment (FGA) is a valuable tool for classifying fall risk based on an individual's gait performance. It allows healthcare professionals, particularly physical therapists, to identify and categorize patients who may be at an increased risk of falling.

Identifying prospective falls:

By incorporating tasks that simulate real-world challenges, the FGA aids in identifying prospective falls. The assessment's focus on walking speed, gait velocity, and the ability to make significant adjustments at slow speeds provides insights into an individual's fall risk.

Reliable and valid measure:

The FGA is a reliable and valid measure for assessing gait stability. Its published criterion scores and established cutoff scores contribute to the assessment's credibility, ensuring consistency in evaluating an individual's functional mobility.

Determine concurrent validity:

Healthcare professionals can use the FGA to determine concurrent validity, comparing its results with other established measures. This helps validate the assessment's effectiveness in providing insights into gait deviations and fall risk.

Wide applicability in community-dwelling adults:

The FGA's design makes it applicable to a diverse population of community-dwelling adults, particularly those aged thirty-five and older. It considers this demographic's unique challenges and provides a comprehensive evaluation of gait through tasks like walking in a straight line and making pivot turns safely.

Test-retest reliability and ceiling effect mitigation:

The FGA offers test-retest reliability, ensuring consistent results over repeated assessments. It mitigates the ceiling effect by including tasks that challenge individuals in various directions, such as walking backward and attempting to clear obstacles safely, providing a more nuanced evaluation.

In summary, the free Functional Gait Assessment presents several benefits, including its role in classifying fall risk, identifying prospective falls, serving as a reliable and valid measure, determining concurrent validity, being widely applicable to community-dwelling adults, and ensuring test-retest reliability while mitigating the ceiling effect. These attributes collectively make it a valuable tool for healthcare professionals, especially physical therapists, in assessing and addressing gait-related concerns.

Why use this Functional Gait Assessment app?

Carepatron is a leading platform for Functional Gait Assessment (FGA) in the field of physical therapy. It offers a comprehensive practice management software that integrates the app into daily workflows, allowing practitioners to focus on patient care. The platform also features advanced electronic patient records, ensuring accurate and secure documentation of FGAs. This allows practitioners to track progress and make informed decisions for patient care.

Carepatron's patient portal software enhances patient engagement by providing access to their FGA results and related information. This transparency fosters a collaborative approach to care and empowers patients to participate actively in their rehabilitation journey. The platform is specifically designed for physical therapy EMR, offering specialized features.

The user-friendly interface of the Functional Gait Assessment app on Carepatron makes it easy for healthcare professionals to navigate through the assessment process. It prioritizes data security and compliance with healthcare regulations, ensuring patient information, including FGA results, is stored and transmitted securely.

Integrating the Functional Gait Assessment app into Carepatron's platform enhances efficiency by streamlining the assessment process. Automating repetitive tasks allows practitioners to allocate more time to direct patient care, ultimately improving overall clinic productivity.

Carepatron is the optimal platform for professionals conducting Functional Gait Assessments due to its comprehensive practice management software, advanced electronic patient records, patient portal capabilities, specialization in physical therapy EMR, user-friendly interface, emphasis on security and compliance, and commitment to efficiency and time-saving. Try it today!