Responsiveness and Minimal Detectable Change of the Dynamic Gait Index and Functional Gait Index in Persons With Balance and Vestibular Disorders

Marchetti, Gregory F.; Lin, Chia-Cheng; Alghadir, Ahmad H.; Whitney, Susan L.

doi:10.1097/npt.0000000000000015

Cited by 59 publications

(61 citation statements)

References 18 publications

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“…Both the DGI and the FGA were found to be significantly responsive for those patients who show a clinically important change on the DHI. 20 These results suggest that both physical and self-report outcome measures have the ability to detect meaningful change in a vestibular population. Further directions for this study would be to examine the responsiveness of these measures for individuals who have received treatment interventions for vertigo, dizziness, and unsteadiness.…”

Section: Discussionmentioning

confidence: 83%

Responsiveness of Self-Report Measures in Individuals With Vertigo, Dizziness, and Unsteadiness

Friscia¹,

Morgan²,

Sparto³

et al. 2014

Otology &Amp; Neurotology

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Objective The responsiveness (sensitivity to change) of many self-report measures commonly used with individuals who have balance and vestibular dysfunction has not been assessed. The purpose of this study was to determine the responsiveness of four self-report measures including the Activities-specific Balance Confidence (ABC) scale, the Dizziness Handicap Inventory (DHI), the Falls Efficacy Scale-International (FES-I), and the Vestibular Activities and Participation (VAP) scale in people seeking treatment for vertigo, dizziness, and unsteadiness. Study design A prospective descriptive study. Patients Forty-five patients (mean age 56 y, range 18–79 y) with vertigo, dizziness, and unsteadiness were included. Main outcome measures Participants completed the measures at their initial physician examination and four to six weeks later. The follow-up visit included a Global Rating of Change Scale (GROC). The change in total scores for each self-report measure from initial visit to follow-up visit were recorded and compared against the GROC. A Spearman correlation was performed to determine the relationship between all four self-report measures and the GROC. A Receiver Operating Characteristic (ROC) curve was also used to evaluate responsiveness. Results Significant correlations were found between the GROC and ABC (ρ = 0.50), DHI (ρ = 0.61), and FES-I (ρ = 0.36), but not the VAP (ρ = 0.27). The ROC curve analysis showed that the area under the curve was significantly greater than 0.5 for the ABC, DHI and FES-I. Conclusion The DHI demonstrated the greatest responsiveness, with an optimal cutoff of a change in 3 points related to significant change.

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Section: Discussionmentioning

confidence: 83%

Responsiveness of Self-Report Measures in Individuals With Vertigo, Dizziness, and Unsteadiness

Friscia¹,

Morgan²,

Sparto³

et al. 2014

Otology &Amp; Neurotology

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“…28,31 When interpreting the current findings, it is important to consider that the MCID value for a particular measure may vary depending on the anchor, setting, patient population, and diagnosis. 3 21 Another consideration is that the sample in the study by Marchetti et al 21 was younger (mean ageϭ55 years) than the current sample, so the higher estimate for the FGA MCID value may reflect these younger patients' higher These discrepancies suggest that psychometric properties such as the MCID and the MDC need to be studied from a variety of approaches on a variety of patient groups.…”

Section: Mcid Of the Fgamentioning

confidence: 84%

“…19 Several psychometric properties of the FGA have been established (including good reliability, 17 internal consistency, 17 and moderate concurrent validity 20 ) with other balance measures in patients with vestibular disorders. In addition, Marchetti et al 21 reported an 8-point MCID for the FGA in people with vestibular disorders using an 18-point change on the Dizziness Handicap Inventory (DHI) 22 as the external anchor. This 18-point change on the DHI has been related to standard error of measurement of the instrument and is thought to indicate an improvement in disability level.…”

Section: What New Information Does This Study Offer?mentioning

confidence: 99%

Minimal Clinically Important Difference of the Functional Gait Assessment in Older Adults

Beninato

Fernandes²,

Plummer

2014

Physical Therapy

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“…The performance on the items of the DGI is measured on a 4-point ordinal scale (0–4), with higher scores indicating better performance and a maximum score of 24 [74]. The psychometric properties of the DGI have been well tested with several reports of reliability, validity, and sensitivity in varied clinical populations, including stroke [71–73, 75–79, 125], as presented in Table 2. Seven of the eight items on the DGI assessment involve walking adaptability capturing 5 domains of walking adaptability (obstacle negotiation, postural transitions, temporal demands, terrain demands, and maneuvering in traffic) (Table 3).…”

Section: Existing Performance-based Clinical Assessments Of Walkinmentioning

confidence: 99%

Walking Adaptability after a Stroke and Its Assessment in Clinical Settings

Balasubramanian

Clark

Fox

2014

Stroke Research and Treatment

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Control of walking has been described by a tripartite model consisting of stepping, equilibrium, and adaptability. This review focuses on walking adaptability, which is defined as the ability to modify walking to meet task goals and environmental demands. Walking adaptability is crucial to safe ambulation in the home and community environments and is often severely compromised after a stroke. Yet quantification of walking adaptability after stroke has received relatively little attention in the clinical setting. The objectives of this review were to examine the conceptual challenges for clinical measurement of walking adaptability and summarize the current state of clinical assessment for walking adaptability. We created nine domains of walking adaptability from dimensions of community mobility to address the conceptual challenges in measurement and reviewed performance-based clinical assessments of walking to determine if the assessments measure walking adaptability in these domains. Our literature review suggests the lack of a comprehensive well-tested clinical assessment tool for measuring walking adaptability. Accordingly, recommendations for the development of a comprehensive clinical assessment of walking adaptability after stroke have been presented. Such a clinical assessment will be essential for gauging recovery of walking adaptability with rehabilitation and for motivating novel strategies to enhance recovery of walking adaptability after stroke.

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Responsiveness and Minimal Detectable Change of the Dynamic Gait Index and Functional Gait Index in Persons With Balance and Vestibular Disorders

Cited by 59 publications

References 18 publications

Responsiveness of Self-Report Measures in Individuals With Vertigo, Dizziness, and Unsteadiness

Responsiveness of Self-Report Measures in Individuals With Vertigo, Dizziness, and Unsteadiness

Minimal Clinically Important Difference of the Functional Gait Assessment in Older Adults

Walking Adaptability after a Stroke and Its Assessment in Clinical Settings

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