Investigating the Relationship of the Functional Gait Assessment to Spatiotemporal Parameters of Gait and Quality of Life of Individuals With Stroke

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Abstract

Background and Purpose:

Walking in the community is an important aspect of independence and quality of life (QOL) that poses challenges for individuals with stroke. This study investigated whether performance on the Functional Gait Assessment (FGA) differentiated spatiotemporal gait parameters, QOL, and fall history of community-ambulating individuals with stroke. We hypothesized that those scoring higher on the FGA would present with better gait speed and cadence, stride width and length, and improved load time on the paretic limb, report a higher QOL, and be less likely to have a fall history than those who scored lower on the FGA.

Methods:

Participants were screened for cognitive impairment and the ability to walk independently. Participant demographics and stroke characteristics were recorded. The Falls Risk for Older People in the Community (FROP-Com) screening tool determined whether the participant had incurred 1 or more falls within the preceding 12 months. The FGA provided a composite measure of gait with varied walking tasks challenging different aspects of walking. The total score was recorded. The GAITRite instrumented-walkway was used to acquire high-resolution footfall data during performance of the first 9 FGA walking tasks. The Assessment of Quality of Life-6D (AQoL-6D) was used to measure health-related QOL across the domains of independent living, mental health, coping, relationships, pain, and senses. Pearson and Spearman correlations were used to check for correlations between FGA score and the demographic characteristics, AQoL-6D scores, and 12-month fall history. Pearson correlations were used to check for correlations between FGA score and multiple spatiotemporal gait parameters for each FGA item.

Results and Discussion:

A sample of 29 volunteers who were community-ambulating individuals with stroke was recruited. Participants had a mean age of 62.31 (10.89) years, mean time since stroke of 3.78 (4.10) years, and included both males and females (52% male). Individuals presented with both left- and right-sided strokes. FGA score correlated positively with velocity, cadence, and step length, and negatively with stride width, double-support percent, and single-support variability (P = .001 to P = .031). FGA score correlated positively with the AQoL-6D dimension of independent living. FGA score correlated significantly with the FROP-Com screening tool predicted fall risk, but not with fall history.

Conclusions:

The FGA is a clinical measure of functional gait performance that reflected spatiotemporal gait parameters and ability of individuals with chronic stroke to live independently. The FGA could be used to target interventions to improve functional gait performance of individuals with chronic stroke.

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