The Functional Gait Assessment is an outcome measure that is designed to measure challenges
to gait outside of traditional measures that focus either on balance or steady-state gait.
The test encompasses 10 separate tasks that objectively measure an individual's ability
to perform various functional tasks in gait.
This video will show you how to set up the Functional Gait Assessment, perform the tests
with examples of normal performance, and discuss how a patient's score can be used in a clinical
setting.
The first thing to do is to find a 20 foot distance, or about 6 meters, to perform the
test.
Measure the 20 foot distance and place a marker at each end.
Next, measure a 12 inch, or 1 foot width along the walkway.
You can use markers on the ground, such as tape, or use two markers at each end to visualize
a 12 inch wide walkway.
If your setting has tiled floors, many tiles are 12 inches wide and can be an easy method
to measure the walkway.
Other equipment you will need include: a stopwatch, two shoe boxes, and stairs (preferably with
at least 4 steps and rails on both sides).
Tape the shoe boxes together, creating an approximately 9 inch obstacle.
The following 10 tasks will be presented with normal performance.
When performing the Functional Gait Assessment in your setting, use a copy of the Functional
Gait Assessment tool to refer to descriptions for each level of performance.
As you explain the tasks, be sure to demonstrate performance to the patient to ensure understanding
and proper technique.
Instruct the patient to walk the 20 foot test distance saying, "Walk at your normal speed
from here to the next mark."
Using a stopwatch, measure the time that the patient requires to walk the 20 foot distance,
and score as indicated.
Instruct the patient saying, “Begin walking at your normal pace.
When I tell you to walk “fast”, walk as fast as you can.
When I tell you to walk “slow,” walk as slowly as you can."
Have the patient walk at each speed for about 5 feet before changing speeds.
Instruct the patient saying, “Walk from here to the next mark 20 feet away.
Begin walking at your normal pace.
Keep walking straight; after 3 steps, turn your head to the right and keep walking straight
while looking to the right.
After 3 more steps, turn your head to the left and keep walking straight while looking
to the left.
Continue alternating looking right and left every 3 steps until you have completed 2 repetitions
in each direction.”
Alternatively, you can cue the patient to turn their head while you count their steps.
THERAPIST: "Look right, look left, look right, look left"
Instruct the patient saying, “Walk from here to the next mark 20 feet away.
Begin walking at your normal pace.
Keep walking straight; after 3 steps, tip your head up and keep walking straight while
looking up.
After 3 more steps, tip your head down, and keep walking straight while looking down.
Continue alternating looking up and looking down until you have completed 2 repetitions
in each direction.”
As with the horizontal head turns, you can cue the patient to turn their head while you
count their steps.
THERAPIST: "...look down, look up, look down."
Instruct the patient saying, “Begin with walking at your normal pace.
When I tell you to, “turn and stop,” turn as quickly as you can and face the opposite
direction and stop.”
Using a stopwatch, start timing as soon as the patient begins to turn, and stop once
they have completed the turn.
THERAPIST: "Turn and stop."
Prepare the walkway by placing your 9 inch shoe box obstacle near the middle of the walkway.
Instruct the patient saying, “Begin walking at your normal speed.
When you come to the shoe box, step over it, not around it, and keep walking.”
If the patient is unable to step over the obstacle, perform the task a second time using
one shoe box as an obstacle and score as indicated.
Once complete, remove the obstacle from the walkway.
Instruct the patient saying, “Walk on the floor with arms folded across the chest, and
feet aligned heel to toe.”
The number of steps taken in a straight line are counted for a maximum of 10 steps.
Score as indicated.
Note that this test can be performed in parallel bars if needed, but is best when performed
in your walkway.
Instruct the patient, saying, “Walk at your normal speed from here to the next mark with
your eyes closed.”
Using a stopwatch, measure the time that the patient requires to walk the 20 foot distance,
and score as indicated.
It is important that you guide the patient to avoid obstacles, to stop at the appropriate
time, and to guard in case of a loss of balance.
Instruct the patient, saying, “Walk backwards until I tell you to stop.”
Have the patient walk the distance of the walkway and score as indicated.
Instruct the patient saying, “Walk up these stairs as you would at home, using the rail
if necessary.
At the top, turn around and walk down.”
Score as indicated.
Once you have completed all 10 tasks, add up the scores for each task.
Perfect performance of the Functional Gait Assessment would yield a score of 30.
The sum that you receive is expressed as the score out of 30.
For example 19 out of 30.
When used with current clinical statistics, such as those found on missiongait.org, you
can use the Functional Gait Assessment score for effective patient education, outcome measurement,
and determination of fall risk.
Thank you for watching this video, and we hope you can bring this great tool into your
clinic.
If you want to learn more about this test, including current statistics, Mission Gait
has a free ‘Functional Gait Assessment Toolkit’ available on missiongait.org.
It includes a ready-to-go in-service, clinical statistics, and more.
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