Functional Gait Assessment: Concurrent, Discriminative, and Predictive Validity in Community-Dwelling Older Adults
Open Access
- 1 May 2010
- journal article
- Published by Oxford University Press (OUP) in PTJ: Physical Therapy & Rehabilitation Journal
- Vol. 90 (5), 761-773
- https://doi.org/10.2522/ptj.20090069
Abstract
The Functional Gait Assessment (FGA) is a reliable and valid measure of gait-related activities. The purpose of this study was to determine the concurrent, discriminative, and predictive validity of the FGA in community-dwelling older adults. This was a prospective cohort study. Thirty-five older adults aged 60 to 90 years completed the Activities-specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Timed “Up & Go” Test (TUG), and Functional Gait Assessment (FGA) during one session. Falls were tracked by having participants complete a monthly fall calendar for 6 months. Spearman correlation coefficients were used to determine concurrent validity among the ABC, BBS, TUG, DGI, and FGA. To determine the optimum scores to classify fall risk, sensitivity (Sn), specificity (Sp), and positive and negative likelihood ratios (LR+ and LR−) were calculated for the FGA in classifying fall risk based on the published criterion scores of the DGI and TUG and for the FGA, TUG, and DGI in identifying prospective falls. Receiver operator curves with area under the curve were used to determine the effectiveness of the FGA in classifying fall risk and of the DGI, TUG, and FGA in identifying prospective falls. The FGA correlated with the ABC (r=.053, P<.001), BBS (r=.84, P<.001), and TUG (r=−.84, P<.001). An FGA score of ≤22/30 provides both discriminative and predictive validity. The FGA (scores ≤22/30) provided 100% Sn, 72% Sp, LR+ of 3.6, and LR− of 0 to predict prospective falls. The study was limited by the length of time of follow-up and the small sample size that did not allow for evaluation of criterion scores by decade. The FGA with a cutoff score of 22/30 is effective in classifying fall risk in older adults and predicting unexplained falls in community-dwelling older adults.Keywords
This publication has 36 references indexed in Scilit:
- The reliability and predictive accuracy of the falls risk for older people in the community assessment (FROP-Com) toolAge and Ageing, 2008
- Prognostic validity of the Timed Up-and-Go test, a modified Get-Up-and-Go test, staff's global judgement and fall history in evaluating fall risk in residential care facilitiesAge and Ageing, 2008
- Use of the Berg Balance Scale for Predicting Multiple Falls in Community-Dwelling Elderly People: A Prospective StudyPTJ: Physical Therapy & Rehabilitation Journal, 2008
- Reliability and concurrent validity of the Expanded Timed Up‐and‐Go test in older people with impaired mobilityPhysiotherapy Research International, 2008
- Reference group data for the functional gait assessmentPTJ: Physical Therapy & Rehabilitation Journal, 2007
- Interventions to Reduce Fear of Falling in Community‐Living Older People: A Systematic ReviewJournal of the American Geriatrics Society, 2007
- Guideline for the Prevention of Falls in Older PersonsJournal of the American Geriatrics Society, 2001
- Reducing falls in elderly people: A review of exercise interventionsPhysiotherapy Theory and Practice, 1999
- Psychological Indicators of Balance Confidence: Relationship to Actual and Perceived AbilitiesThe Journals of Gerontology: Series A, 1996
- The Activities-specific Balance Confidence (ABC) ScaleThe Journals of Gerontology: Series A, 1995