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Validity of the Dynamic Gait Index in People With Multiple Sclerosis
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.ORCID iD: 0000-0002-6768-5740
Mälardalen Hospital, Eskilstuna, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.ORCID iD: 0000-0002-9760-3785
2013 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 93, no 10, p. 1369-1376Article in journal (Refereed) Published
Abstract [en]

Background. Evaluation of walking capacity and risk of falls in people with multiple sclerosis often are performed in rehabilitation. The Dynamic Gait Index (DGI) evaluates walking during different tasks, but the feasibility in identifying people at risk for falls needs to be further investigated. Objective. The objective of this study was to investigate (1) the construct validity (known groups, convergent, and discriminant) of the DGI and (2) the accuracy of predicting falls and establishing a cutoff point to identify fallers. Design. This trial was a multicenter, cross-sectional study.

Methods. A convenience sample was composed of 81 people with multiple sclerosis with subjective gait and balance impairment who were able to walk 100 m (comparable to Expanded Disability Status Scale 1-6). Mean age of the participants was 49 years; 76% were women. The 25-Foot Timed Walk Test, Timed "Up & Go" Test, Four Square Step Test, Timed Sit-to-Stand Test, MS Walking Scale, Multiple Sclerosis Impact Scale, and self-reported falls during the previous 2 months were used for validation, to establish cutoff points for identifying fallers, and to investigate predictive values.

Results. Significantly lower DGI scores (P <=.001) were found for participants reporting falls (n=31). High sensitivity (87%) in identifying falters was found, with a cutoff score <= 19. The positive predictive value was 50%, and the negative predictive value was 87%. The positive likelihood ratio was 1.77, and the negative likelihood ratio was 0.26. The convergent validity was moderate to strong (rho=0.58-0.80), with the highest correlation coefficient found for the 25-Foot Timed Walk Test. Discriminant validity was shown with low correlation for the psychological subscale of the Multiple Sclerosis Impact Scale. Limitations. The sample included ambulatory people participating in a randomized controlled trial investigating balance training.

Conclusions. The DGI is a valid measure of dynamic balance during walking for ambulatory people with multiple sclerosis. With the cutoff point of <= 19, sensitivity was high in identifying people at risk of falls.

Place, publisher, year, edition, pages
2013. Vol. 93, no 10, p. 1369-1376
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-32402DOI: 10.2522/ptj.20120284ISI: 000324971100008OAI: oai:DiVA.org:oru-32402DiVA, id: diva2:664993
Note

Funding agency: Uppsala-Orebro Regional Research Council; Research Committee of Orebro County Council; Norrbacka-Eugenia Foundation

Available from: 2013-11-18 Created: 2013-11-15 Last updated: 2017-12-06Bibliographically approved

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Forsberg, AnetteNilsagård, Ylva E.

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