Validation of the Malta Gait Scale: A Time-Efficient Tool for Poststroke Assessment

Area of Science:

• Rehabilitation Medicine
• Neurology
• Biomedical Engineering

Background:

• Stroke survivors frequently experience walking dysfunction, significantly impacting their quality of life.
• Accurate gait assessment is vital for effective rehabilitation, yet gold-standard methods are costly and time-intensive.
• Observational gait analysis (OGA) is common but can be time-consuming; validated, efficient tools are needed.

Purpose of the Study:

• To validate the Malta Gait Scale (MGS), a concise, illustrated 7-item observational tool for gait measurement.
• To assess the MGS's reliability, concurrent validity, and time efficiency compared to established scales (WGS, GAIT).
• To determine the MGS's efficacy in detecting rehabilitation-induced gait changes and differentiating stroke patients from healthy individuals.

Main Methods:

• A retrospective study involving 49 participants to validate the MGS.
• Assessed intrarater and interrater reliability using weighted Cohen's kappa (κ).
• Evaluated concurrent validity against the Wisconsin Gait Scale (WGS) and Gait Assessment Intervention Tool (GAIT) using Spearman's rho (ρ); assessed time efficiency and clinical utility via Wilcoxon tests.

Main Results:

• The MGS demonstrated excellent reliability with interrater κ=0.952 and intrarater κ=0.977.
• High positive correlations were found between MGS and WGS (ρ=0.898) and GAIT (ρ=0.877).
• MGS administration averaged 7 min 29 s, significantly faster than WGS (27 min 46 s) and GAIT (50 min 6 s). Significant improvements were noted post-rehabilitation (p=0.018), and MGS distinguished between healthy and stroke groups (p<0.001).

Conclusions:

• The Malta Gait Scale (MGS) is a valid, reliable, and highly time-efficient tool for gait assessment in stroke survivors.
• Its ease of use, suitability for video recording (including smartphone use), and speed make it ideal for clinical settings.
• The MGS supports effective gait evaluation, facilitating tailored rehabilitation programs and rapid clinical decision-making.