Functional Gait Assessment (FGA)
What it measures:
The Functional Gait Assessment (FGA) is used to assess postural stability and balance during different tasks in populations of patients with Parkinson disease, spinal cord injuries, stroke diagnosis, and vestibular disorders. FGA is a modification of the Dynamic Gait Index and was created to help decrease the ceiling effect and improve reliability.(1)
This summary contains information on use of this test in patients or clients with Parkinson disease, vestibular disorders, stroke, multiple sclerosis, benign paroxysmal positional vertigo (BPPV), orthostatic tremor, and total knee arthroplasty, and other conditions.
A clinical practice guideline recommends the use of the Functional Gait Assessment for adults with various neurologic conditions undergoing rehabilitation that have goals of improving their walking balance and have the ability to improve in this area.(4)
EDGE documents state recommendations for use of FGA across several neurological conditions. Spinal Cord Injury EDGE recommended that FGA is reasonable to use in acute and subacute strokes, but there is limited research with this group. However, FGA is not recommended for use in patients with chronic stroke.(42) Vestibular EDGE highly recommends the use of FGA in patients with chronic symptoms, and states FGA is reasonable to use in acute patients with limited research in this group. Additionally, FGA is highly recommended for patients with peripheral and central symptoms. Use of FGA with patients with BPPV is considered to have limited studies, but is reasonable to use.(43) EDGE documents state that FGA is highly recommended for use with patients with Parkinson disease, with the exception of stage V on the Hoehn and Yahr Scale.(44) Multiple sclerosis EDGE reports that it is unable to recommend FGA across different settings, including acute care, inpatient rehabilitation, skilled nursing facilities, outpatients, and home health.(45) TBI EDGE reports FGA is reasonable to use, but there were limited studies done for this group. The EDGE report also states that FGA is not recommended for patients with TBI who are moderately or severely dependant.(46)
FGA is an inexpensive, quick, and easy test to administer in any setting. Minimal training is needed to administer the test, but clinicians should be cautious with which population they use it on. Healthy individuals, especially younger populations, tend to reach the upper limit of the test. Populations with a variety of diagnoses and healthy elderly populations often do not reach the upper limit, suggesting that FGA may be a suitable test to use in these groups. FGA can also be used to assess change in disease process (eg, patients with Parkinson disease) and can help to see if treatment needs modification, justify PT visits, and alert health care professionals of the patient's functional abilities. Additionally, use of medication can impact the results of FGA. For example, patients with Parkinson disease may demonstrate a better representation of their abilities if the test is conducted during the "off" timing of their medications. Cognition could also impact the results of the test and reliability could be different for different diagnoses. Further research is needed to determine the validity of FGA across various settings.
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