Gait abnormalities in older people--comparison of inter-professional assessment

Gait abnormalities are common in older people but relatively under-diagnosed. We investigated the prevalence of gait abnormalities among patients presenting to a geriatric medicine day hospital, classified them according to whether they were lower, middle or higher level gait disorders and compared inter-professional (physician and physiotherapist) assessments for this classification. Prospective independent assessment by a physician and a senior physiotherapist of 50 consecutive patients presenting to a day hospital. Presence of a gait abnormality was determined and then classified. Levels of agreement were determined between the two professions. There was 98% agreement that a gait abnormality existed in 43 people. In classifying the gait abnormality there was complete agreement in over two-thirds of cases (67.4%). There was further agreement of higher level gait disorders (but disagreement in the sub-classification) in 11.6% of cases. Given the high prevalence of gait abnormality presenting to the day hospital, screening for gait and balance disorders should be of paramount importance. While levels of agreement between the two professions were high, disagreement existed in approximately one-third of cases. Agreement among professionals essential for appropriate tailoring of treatment and intervention.