The Functional Gait Assessment in People with Multiple Sclerosis: Validity and Sensitivity to Change

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Balance and walking assessments are crucial in multiple sclerosis (MS) rehabilitation.
• The Functional Gait Assessment (FGA) evaluates walking balance with challenging tasks.
• Investigating the FGA's validity and sensitivity to change in ambulatory MS individuals is essential.

Purpose of the Study:

• To assess the concurrent, discriminant, and known-groups validity of the modified FGA in ambulatory individuals with MS.
• To evaluate the sensitivity to change of the modified FGA.

Main Methods:

• 87 individuals with MS participated in the study.
• Validity was examined using dynamic balance tests, the Multiple Sclerosis Walking Scale, and the Multiple Sclerosis Impact Scale (MSIS).
• Known-groups validity involved fall history and walking device use; sensitivity to change used data from a balance training study.

Main Results:

• The median FGA score was 15.
• Moderate to strong concurrent validity was found with dynamic balance tests (e.g., Timed Up and Go, rho = -0.74).
• Discriminant validity was supported by a low correlation with the MSIS psychological subscale (rho = 0.14); FGA scores differed between walking device users and non-users, but not significantly for reported falls. Sensitivity to change was moderate to low.

Conclusions:

• The FGA demonstrates validity as a measure of walking balance in individuals with MS.
• Further investigation is required to establish the FGA's capability in identifying individuals at risk for falls.