Reliability and Validity of the Functional Gait Assessment in Incomplete Spinal Cord Injury

Abstract

Background:

There are limited psychometrically sound measures to assess higher level balance in individuals with incomplete spinal cord injury (iSCI).

Objectives:

To evaluate interrater and intrarater reliability and convergent validity of the Functional Gait Assessment (FGA) in individuals with iSCI.

Methods:

Twelve participants (11 male, 1 female) 32 to 73 years old with chronic motor iSCI, American Spinal Injury Association Impairment Scale C ( n = 2) or D ( n = 10), were included. Participants completed five outcome measures during a single test session including lower extremity motor scores from the International Standards for the Neurological Classification of Spinal Cord Injury, FGA, 10-Meter Walk Test (10MWT), Walking Index for Spinal Cord Injury (WISCI-II), and the Spinal Cord Injury Functional Ambulation Profile (SCI-FAP).

Results:

Inter- and intrarater reliability for the FGA were excellent. Interrater reliability was excellent with intraclass correlation coefficient (ICC) scores greater than 0.92 ( p < .001). Interrater reliability against an expert was also excellent for all raters, with an ICC greater than or equal to 0.92 ( p < .01). Intrarater reliability was excellent with an ICC score of greater than 0.91 ( p < .002) for all raters. Validity of the FGA with 10MWT was −0.90 ( p = .000), FGA with WISCI-II was 0.74 ( p = .006), and FGA with SCI-FAP was −0.83 ( p = .001).

Conclusion:

The FGA is a reliable and valid outcome measure to use when assessing gait and balance in individuals with motor iSCI. The FGA provides clinicians with a single tool to utilize across a variety of neurologic diagnoses.