The Functional Gait Assessment in People with Multiple Sclerosis

Abstract

Background: Assessments of balance and walking are often performed in rehabilitation of people with multiple sclerosis (MS). The Functional Gait Assessment (FGA) is a test of walking balance including challenging items such as walking with a narrow base of support, with eyes closed, and backward. The aim was to investigate the validity (concurrent, discriminant, and known-groups) and sensitivity to change of the modified FGA in ambulatory individuals with MS. Methods: A convenience sample of 87 individuals with MS was included (mean age, 54 years; 79% women). Concurrent and discriminant validity was investigated using tests of dynamic balance and the Multiple Sclerosis Walking Scale and Multiple Sclerosis Impact Scale (MSIS). Known-groups validity was investigated with self-reported number of falls and use of walking devices. Sensitivity to change was investigated with data from a group balance training study. Results: The median FGA score was 15 (range, 1–26). Concurrent validity with tests of dynamic balance was moderate to strong, with the Timed Up and Go test having the highest correlation coefficient (rho = −0.74). Discriminant validity was shown with a low correlation coefficient with the MSIS psychological subscale (rho = 0.14). The FGA scores differed significantly for users of walking devices versus nonusers but not for reported falls. Sensitivity to change was moderate to low. Conclusions: The FGA is a valid measure of balance during walking in people with MS, but further investigation is required for the ability to detect people at risk for falls.