The Functional Gait Assessment in Older Adults: Validation Through Rasch Modeling
The Functional Gait Assessment in Older Adults: Validation Through Rasch Modeling
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DOI：
10.2522/ptj.20150167
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发表时间：
2016-04-01
期刊：
影响因子：
3.2
通讯作者：
Ludlow, Larry H.
中科院分区：
文献类型：
--
作者：
Beninato, Marianne;Ludlow, Larry H.
背景。功能步态评估 (FGA) 是一种步行平衡能力的衡量标准，旨在消除动态步态指数 (DGI) 中观察到的天花板效应。从最初的 8 项 DGI 任务中添加了 3 项可能更困难的任务，并删除了 1 项较简单的任务。之前尚未分析这些修改对项目层次结构的影响。目标。本研究的目的是确定：(1) 10 个 FGA 任务的顺序以及它们沿着临床逻辑难度连续体映射的程度，(2) 任务的分布是否足以测量不同功能能力水平的患者而没有天花板效应，(3) 3 个添加的任务沿着任务难度连续体的位置，以及 (4) 各个 FGA 任务的心理测量特性。设计。进行了回顾性图表审查。方法。通过 Rasch 模型分析了 179 名接受物理治疗以进行平衡再训练的老年人的功能步态评估分数。结果。 FGA 任务层次结构满足临床预期，但“水平行走”任务除外，该任务位于难度连续体的中间。没有天花板效应。添加的 3 个任务中有两个是最困难的 FGA 任务。在最困难的任务（“支撑基础较窄的步态”）上的表现表现出比 Rasch 模型预测的更大的可变性。局限性。样本仅限于居住在社区且独立行走的老年人。研究结果不能推广到其他患者群体。结论。修订后的 FGA 评分标准可能会影响项目层次结构。结果表明，FGA 是衡量老年人步行平衡能力的指标，在临床上是合适的，并且具有结构效度。 FGA 的管理可以进一步修改以提高管理效率。
Background. The Functional Gait Assessment (FGA), a measure of walking balance ability, was developed to eliminate the ceiling effect observed in the Dynamic Gait Index (DGI). Three presumably more difficult tasks were added and 1 easier task was removed from the original 8 DGI tasks. The effects of these modifications on item hierarchy have not previously been analyzed.Objective. The purpose of this study was to determine: (1) the ordering of the 10 FGA tasks and the extent to which they map along a clinically logical difficulty continuum, (2) whether the spread of tasks is sufficient to measure patients of varying functional ability levels without a ceiling effect, (3) where the 3 added tasks locate along the task difficulty continuum, and (4) the psychometric properties of the individual FGA tasks.Design. A retrospective chart review was conducted.Methods. Functional Gait Assessment scores from 179 older adults referred for physical therapy for balance retraining were analyzed by Rasch modeling.Results. The FGA task hierarchy met clinical expectations, with the exception of the "walking on level" task, which locates in the middle of the difficulty continuum. There was no ceiling effect. Two of the 3 added tasks were the most difficult FGA tasks. Performance on the most difficult task ("gait with narrow base of support") demonstrated greater variability than predicted by the Rasch model.Limitations. The sample was limited to older adults who were community dwelling and independently ambulating. Findings cannot be generalized to other patient groups.Conclusions. The revised scoring criteria of the FGA may have affected item hierarchy. The results suggest that the FGA is a measure of walking balance ability in older adults that is clinically appropriate and has construct validity. Administration of the FGA may be modified further to improve administration efficiency.