Article

The Functional Gait Assessment (FGA) is a reliable and valid measure
of gait-related activities. OBJECTIVE: The purpose of this study was to determine
the concurrent, discriminative, and predictive validity of the FGA in
community-dwelling older adults. DESIGN: This was a prospective cohort study.
METHODS: 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. RESULTS: 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 <or=22/30 provides both discriminative and predictive validity. The
FGA (scores <or=22/30) provided 100% Sn, 72% Sp, LR+ of 3.6, and LR- of 0 to
predict prospective falls. Limitations 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. CONCLUSIONS: 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.

Langue : ANGLAIS