Introduction
The dynamic gait index is addressed to patients who are at risk of fall because of different causes, including old age, Parkinson’s disease, multiple sclerosis.
This is a simple evaluation of balance and ability to perform several activities and can help monitor the status of patients with vestibular conditions.
The index can be administered in about 15 minutes and needs to take place in a space where stairs are easily available, as well as a 20’ walkaway that is 15” wide. Also, a box (shoebox) and 2 cones are used.
Use the following EVALUATION FORM to evaluate your patient and PRINT THE FORM when the evaluation is completed.
DGI interpretation
As introduced above, each of the eight activities benefits from a customized 4 point scale which can be summarized as follows:
- No gait dysfunction (3 points);
- Minimal impairment (2 points);
- Moderate impairment (1 point);
- Severe impairment (0 points).
The highest possible score obtainable in the DGI is 24 and the lowest is 0. Scores closer to 24 indicate an almost or completely normal condition. Scores closer to 0 indicate a severe gait impairment.
A cut off of 19 points (with 67% sensitivity and 86% specificity) delimits patients at risk of falls (scoring below 19) and those who are unlikely to suffer from prospective falls.
When used in the evaluation of multiple sclerosis patients, a cut off of 12 points is recommended as opposed to that of 19, because of better discrimination between patients who are at risk of falls and those who have good balance.
This index may also be used in the evaluation of recovery of ambulatory patients who have suffered a stroke episode.
Literature
Original sources
1. Herdman SJ. Vestibular Rehabilitation. 2nd ed. Philadelphia, PA: F.A.Davis Co; 2000.
2. Shumway-Cook A, Woollacott M. Motor Control Theory and Applications, Williams and Wilkins Baltimore, 1995: 323-324.
Other references
1. Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil. 2007; 88(11):1410-5.
2. Wrisley DM, Walker ML, Echternach JL, Strasnick B. Reliability of the dynamic gait index in people with vestibular disorders. Arch Phys Med Rehabil. 2003; 84(10):1528-33.
3. Herman T, Inbar-Borovsky N, Brozgol M, Giladi N, Hausdorff JM. The Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender. Gait Posture. 2009; 29(2):237-41.
4. Whitney SL, Hudak MT, Marchetti GF. The dynamic gait index relates to self-reported fall history in individuals with vestibular dysfunction. J Vestib Res. 2000; 10(2):99-105.