Article

The Dynamic Gait Index (DGI) measures the capacity to adapt gait to
complex tasks. The current scoring system combining gait pattern (GP) and level
of assistance (LOA) lacks clarity, and the test has a limited range of
measurement. OBJECTIVE: This study developed a new scoring system based on 3
facets of performance (LOA, GP, and time) and examined the psychometric
properties of the modified DGI (mDGI). DESIGN: A cross-sectional, descriptive
study was conducted. METHODS: Nine hundred ninety-five participants (855 patients
with neurologic pathology and mobility impairments [MI group] and 140 patients
without neurological impairment [control group]) were tested. Interrater
reliability was calculated using kappa coefficients. Internal consistency was
computed using the Cronbach alpha coefficient. Factor analysis and Rasch analysis
investigated unidimensionality and range of difficulty. Internal validity was
determined by comparing groups using multiple t tests. Minimal detectable change
(MDC) was calculated for total score and 3 facet scores using the reliability
estimate for the alpha coefficients. RESULTS: Interrater agreement was strong,
with kappa coefficients ranging from 90% to 98% for time scores, 59% to 88% for
GP scores, and 84% to 100% for LOA scores. Test-retest correlations (r) for time,
GP, and LOA were .91, .91, and .87, respectively. Three factors (time, LOA, GP)
had eigenvalues greater than 1.3 and explained 79% of the variance in scores. All
group differences were significant, with moderate to large effect sizes. The 95%
minimal detectable change (MDC95) was 4 for the mDGI total score, 2 for the time
and GP total scores, and 1 for the LOA total score. LIMITATIONS: The limitations
included uneven sample sizes in the 2 groups. The MI group were patients
receiving physical therapy; therefore, they may not be representative of this
population. CONCLUSIONS: The mDGI, with its expanded scoring system, improves the
range, discrimination, and facets of measurement related to walking function. The
strength of the psychometric properties of the mDGI warrants its adoption for
both clinical and research purposes.

Langue : ANGLAIS