Psychometric properties of functional gait assessment in people with stroke

OBJECTIVE: Walking balance is essential for daily life, especially for people recovering from a stroke. The Functional Gait Assessment (FGA) is a tool commonly used to assess walking stability and predict the risk of falls. However, its reliability and validity in community-dwelling stroke survivors were not well-studied. This study is to investigate the psychometric properties of FGA in people with stroke. METHODS: Sixty-three people with stroke and thirty healthy older adults were recruited to this cross-sectional study. FGA, Fugl-Meyer Assessment Lower Extremity (FMA-LE), Ankle Muscle Strength Test, Montreal Cognitive Assessment (MoCA), Limit of Stability (LOS), Berg Balance Scale (BBS), Foot and Ankle Ability Measure (FAAM), Oxford Participation and Activities Questionnaire (Ox-PAQ), The 12-items Short Form Health Survey (SF-12) were assessed in a randomized order on day 1 and day 2. Healthy subjects only participated in the FGA assessment on day 1. RESULTS: The FGA score demonstrated excellent inter-rater reliability (ICC = 0.94) and good test-retest reliability (ICC = 0.85) in people with stroke. The SEM and MDC of the FGA score were 1.81 and 5.02, respectively. Significant correlations were found between FGA and FMA-LE, ankle strength, BBS, LOS, and FAAM (p < 0.05). The Bland-Altman plots indicated a mean difference of 0.71 with 95% limit of agreement (95%LOA) ranging from - 3.60 to 5.03 for the inter-rater measurements. An optimal cut-off point of ≥ 20 was identified, with lower scores indicating greater gait and balance impairment, effectively differentiating people with stroke from healthy adults. CONCLUSION: FGA is a sensitive, reliable, and efficient tool for assessing gait and balance in people with stroke.