Validity and reproducibility of the Functional Gait Assessment in persons after stroke

Bloemendaal, Maijke van; Bout, Walter; Bus, Sicco A.; Nollet, Frans; Geurts, Alexander C. H.; Beelen, Anita

doi:10.1177/0269215518791000

Cited by 28 publications

(19 citation statements)

References 28 publications

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“…8,12,14,33,35 A possible explanation could be the high level of heterogeneity in mobility in the included participants with Parkinson’s disease, indicated by the relatively large standard deviation of 22 points for the reliability sample (35% of the mean score). The standard error of measurement of 7.5 points, however, was acceptable 29 and there was no item with absolute agreement <70%. Provided that all assessors carefully synchronize before clinical use, the de Morton Mobility Index can be reliably administered by different assessors in hospital patients with Parkinson’s disease.…”

Section: Discussionmentioning

confidence: 83%

“…22 The standard error of measurement (SEM AGREEMENT ) was calculated 27 and deemed satisfactory if it was ⩽10% of the total scale range (100 points). 29 The absolute and relative agreement between both raters per item was calculated as percentage (%) and as weighted kappa with linear weights (ƙ), respectively. 27 Agreement per item equal to or above 70% and ƙ ⩾0.70 were considered acceptable.…”

Section: Methodsmentioning

confidence: 99%

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An investigation of the measurement properties of the de Morton Mobility Index for measuring mobility capacity in hospital patients with Parkinson’s disease

et al. 2020

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Objective: To examine the measurement properties of the de Morton Mobility Index (DEMMI), a performance-based clinical outcome assessment of mobility capacity, in hospital patients with Parkinson’s disease. Design: Cross-sectional study. Participants: Hospital patients with Parkinson’s disease. Main outcome measure(s): Structural validity and unidimensionality (Rasch analysis), construct validity, internal consistency reliability, and inter-rater reliability of the de Morton Mobility Index (scale range: 0–100 points) were established. The minimal detectable change, the 95% limits of agreement and possible floor and ceiling effects were calculated to indicate interpretability. Results: We analysed validity ( n = 100; mean age: 70 years; 71% male) and reliability ( n = 47; mean age: 71 years; 68% male) in two samples. The mean Hoehn and Yahr stage was 3.2 and the mean disease duration was 12 years in both samples. Rasch analysis indicated unidimensionality with an overall fit to the model (chi-square = 21.49, P = 0.122). Seventy-three percent of hypotheses on construct validity were confirmed. Internal consistency reliability (Cronbach’s alpha = 0.91) and inter-rater reliability (intraclass correlation coefficient = 0.88; 95% confidence interval: 0.80 to 0.93) were sufficient. The minimal detectable change with 90% confidence was 17.5 points and the limits of agreement were 31%. No floor or ceiling effects were observed. The mean administration time was 6.6 minutes. Conclusion: This study provides evidence of unidimensionality, sufficient internal consistency reliability, inter-rater reliability, construct validity, and feasibility of the de Morton Mobility Index in hospital patients with Parkinson’s disease. Trial registration: German Clinical Trials Register (DRKS00004681). Registered May 6, 2013.

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Section: Discussionmentioning

confidence: 83%

Section: Methodsmentioning

confidence: 99%

An investigation of the measurement properties of the de Morton Mobility Index for measuring mobility capacity in hospital patients with Parkinson’s disease

et al. 2020

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“…The secondary outcomes of the efficacy study were additional spatiotemporal gait parameters (step time asymmetry index, single-leg stance time asymmetry index, stride length, and stride time) for the barefoot and shod conditions, 34-36 walking capacity measures (walking balance measured with the Functional Gait Assessment 37,38 and comfortable gait speed calculated from the 10-Meter Walk Test 37 ), and balance control measured with the Berg Balance Scale. 39 Furthermore, fear of falling was evaluated by the Falls Efficacy Scale I (score range 16-64) and assessed only at 3-month follow-up.…”

Section: Methodsmentioning

confidence: 99%

Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

Bloemendaal

Bus

Nollet

et al. 2021

Neurorehabil Neural Repair

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Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

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“…39 The standard error of measurement (SEM AGREEMENT ) was calculated and deemed satisfactory if it was ≤ 10% of the total scale range (100 DEMMI points). 47,44 The absolute and relative agreement between both raters per DEMMI item was calculated as a percentage (%) and as the weighted kappa with linear weights ( ). 44 Agreement per item equal or above 70% and ≥ 0.70 was considered acceptable.…”

Section: Reliabilitymentioning

confidence: 99%

A generic outcome assessment of mobility capacity in neurorehabilitation: measurement properties of the de Morton Mobility Index

Braun

Marks

Thiel

et al. 2021

Preprint

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Background: Mobility capacity is a key outcome domain in neurorehabilitation. The de Morton Mobility Index (DEMMI), an established and generic outcome assessment of mobility in older patients, is promising for use in neurorehabilitation.Objective: To examine the measurement properties of the DEMMI in rehabilitation inpatients with neurological conditions.Methods: Cross-sectional study including a mixed sample of adult inpatients in a neurorehabilitation hospital. Structural validity, unidimensionality and measurement invariance (Rasch analysis), construct validity, internal consistency reliability, and inter-rater reliability of the DEMMI (scale range: 0–100 points) were established. The minimal detectable change, the 95% limits of agreement, and possible floor and ceiling effects were calculated to indicate interpretability. Results: We analyzed validity (n = 348) and reliability (n = 133) in two samples. In both samples, the majority of participants had a sub-acute stroke or Parkinson’s disease. Rasch analysis indicated unidimensionality with an overall fit to the model (chi-square = 59.4, P = 0.074). There was no relevant measurement invariance by disease group. All 11 hypotheses on construct validity were confirmed. Internal consistency reliability (Cronbach’s alpha = 0.94) and inter-rater reliability (intraclass correlation coefficient = 0.94; 95% confidence interval: 0.91–0.95) were sufficient. The minimal detectable change with 90% confidence was 15.0 points and the limits of agreement were 39%. No floor or ceiling effects were observed. Conclusions: Results indicate sufficient measurement properties of the DEMMI in rehabilitation inpatients with neurological conditions. The DEMMI can be used as a generic outcome assessment of mobility capacity in neurorehabilitation.Trial registration: German Clinical Trials Register (DRKS00004681). Registered May 6, 2013.

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Validity and reproducibility of the Functional Gait Assessment in persons after stroke

Abstract: The FGA demonstrated good measurement properties in persons after stroke and yielded no ceiling effect in contrast to other capacity measures. In clinical practice, a measurement error of 6 points should be taken into account in interpreting changes in walking balance.

Cited by 28 publications

References 28 publications

An investigation of the measurement properties of the de Morton Mobility Index for measuring mobility capacity in hospital patients with Parkinson’s disease

An investigation of the measurement properties of the de Morton Mobility Index for measuring mobility capacity in hospital patients with Parkinson’s disease

Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

A generic outcome assessment of mobility capacity in neurorehabilitation: measurement properties of the de Morton Mobility Index

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