Does Hands-on Guarding Influence Performance on the Functional Gait Assessment?

Abstract

Background and Purpose: An accurate fall risk assessment is an important component of fall prevention, though a fall could occur during testing. To minimize this risk, different guarding methods are used, though there is disagreement regarding the optimal method. The purpose of this study was to compare the effect of 2 guarding methods, contact guarding (CG) and standby guarding (SG), on performance during the Functional Gait Assessment (FGA). We hypothesized that (1) there would not be a significant difference in FGA scores when comparing CG with SG, and (2) participants would not perceive a difference between the 2 guarding methods. Methods: Twenty-three community-dwelling older adults, mean age 73.6 (SD = 6.2) years, participated in this study. Each participant completed 2 trials of the FGA, one with CG and another with SG. Guarding for all trials was provided by the same experienced physical therapist (PT) for this within-subjects design. All trials were video recorded for review by 2 PT raters who were blinded to the purpose of the study. Results and Discussion: Functional Gait Assessment scores for the 2 PT raters indicated high internal agreement for both CG and SG conditions (CG: intraclass correlation coefficient [ICC] = 0.949; SG: ICC = 0.935), and CG FGA scores did not significantly differ from SG FGA scores (t 22 = 0.15, P = .882). Furthermore, none of the participants perceived a difference in guarding methods. Conclusions: The results of this study indicate that hands-on guarding does not significantly influence performance on the FGA when the guarding is provided by an experienced PT and the participant is a community-dwelling older adult.