Assessing Gait Function in Lower Limb Rehabilitation: The Role of the Gait Analysis and Motion Score (GAMS)

Background: Assessment of gait function is crucial for optimising rehabilitation outcomes. The gait analysis and motion score (GAMS) summarises qualitative and quantitative gait parameters from treadmill-based analyses to evaluate functional walking status. Objectives: To assess the sensitivity of the GAMS for detecting short-term changes, its test-retest reliability, and its correlation with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Timed Up and Go (TUG) test. Methods: A retrospective analysis of 94 inpatient rehabilitation patients with hip, knee, or ankle impairments was performed. Changes in GAMS, WOMAC, and TUG scores and their interrelationships were assessed at both admission and discharge. Results: GAMS, WOMAC, and TUG showed significant improvements over time, with medium effect sizes (η² = 0.303 to 0.434; p < 0.001). No significant differences in outcome measures were observed between groups. Moderate to strong correlations were found between pre- and post-rehabilitation scores for GAMS, TUG, and WOMAC (r = 0.58 to r = 0.90), indicating good test-retest reliability. A significant low negative correlation between GAMS and TUG was observed for all patients at admission (r = -0.30, p = 0.003) and discharge (r = -0.26, p = 0.030). No significant correlations were observed between GAMS and WOMAC in any patient group. Baseline GAMS scores significantly influenced change scores. Conclusions: GAMS is a sensitive and reliable tool for detecting short-term changes in gait parameters. GAMS and TUG assess related but distinct constructs, with GAMS and WOMAC assessing different domains of gait function. Therefore, GAMS provides complementary information not captured by WOMAC or TUG.