Can Observational Gait Assessment Tools be used to Assess Independent Walking in Stroke Patients?

PURPOSE: A gait assessment is an important component of the rehabilitation process, and observational gait assessment (OGA) is used routinely in clinical settings. This study examined the association of OGA tools with the independent walking ability in stroke patients to determine a cutoff value of the OGA tool according to independence levels of stroke patient gait. METHODS: Two hundred ten hemiparetic stroke patients participated in the study. The independence of gait was identified using the Functional Ambulation Category (FAC) classifications. The walking ability was assessed using OGA tools (Rivermead Visual Gait Assessment [RVGA], Wisconsin Gait Scale [WGS], Tinetti Gait Scale [TGS], and Functional Gait Analysis [FGA]). RESULTS: Stepwise multiple regression analysis showed that among the OGA tools, the FGA correlated with the FAC. The FGA explained approximately 77% of the variance in FAC. In distinguishing the independence levels, the cutoff values were as follows: between FAC 1 and FAC 0 was .5 points; between FAC 2 and lower levels, 5.5; between FAC 3 and lower levels, 11.5; between FAC 4 and lower levels, 14.5; and between FAC 5 and lower levels, 18.5. Items 1, 2, 3, and 10 were identified as explaining most of the variance in the FGA in the stepwise multiple regression. CONCLUSION: The present study found that the FGA is an assessment tool related to the level of gait independence after stroke. Furthermore, the FGA total score can serve as an index of the increase in independence level after stroke.