Evidence for the Validity of the Modified Dynamic Gait Index Across Diagnostic Groups (original) (raw)
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Expanding the scoring system for the Dynamic Gait Index
Physical therapy, 2013
The Dynamic Gait Index (DGI) measures the capacity to adapt gait to complex tasks. The current scoring system combining gait pattern (GP) and level of assistance (LOA) lacks clarity, and the test has a limited range of measurement. This study developed a new scoring system based on 3 facets of performance (LOA, GP, and time) and examined the psychometric properties of the modified DGI (mDGI). A cross-sectional, descriptive study was conducted. Nine hundred ninety-five participants (855 patients with neurologic pathology and mobility impairments [MI group] and 140 patients without neurological impairment [control group]) were tested. Interrater reliability was calculated using kappa coefficients. Internal consistency was computed using the Cronbach alpha coefficient. Factor analysis and Rasch analysis investigated unidimensionality and range of difficulty. Internal validity was determined by comparing groups using multiple t tests. Minimal detectable change (MDC) was calculated for t...
Physical therapy, 2006
The Dynamic Gait Index (DGI) is a standardized clinical assessment that aids in evaluating a subject's ability to modify gait in response to changing demands. The purpose of this study was to use Rasch measurement theory to examine whether the DGI rating scale meets suggested psychometric guidelines, whether the hierarchical order of DGI tasks is consistent with a clinically logical testing procedure, and whether the DGI represents a unidimensional construct. Subjects were 84 community-dwelling male veterans (age range=64-88 years; mean+/-SD=75+/-6.47 years). Data were retrieved retrospectively from the participants' clinical records. The Rasch measurement model with the WINSTEPS program was used in this study because it offers distinct advantages over traditional psychometric approaches. Overall, the DGI showed sound item psychometric properties. Each of the original 4 rating scale categories appeared to distinctly identify subjects at different ability levels. The analysis...
Physical therapy, 2014
In the original and modified Dynamic Gait Index (mDGI), 8 tasks are used to measure mobility; however, disagreement exists regarding whether all tasks are necessary. The relationship between mDGI scores and Centers for Medicare & Medicaid Services (CMS) severity indicators in the mobility domain has not been explored. The study objectives were to examine the relationship between medical diagnoses and mDGI scores, to determine whether administration of the mDGI can be shortened on the basis of expected diagnostic patterns of performance, and to create a model in which mDGI scores are mapped to CMS severity modifiers. This was a cross-sectional, descriptive study. The 794 participants included 140 people without impairments (control cohort) and 239 people with stroke, 140 with vestibular dysfunction, 100 with traumatic brain injury, 91 with gait abnormality, and 84 with Parkinson disease. Scores on the mDGI (total, performance facet, and task) for the control cohort were compared with...
2018
Introduction: Dynamic Gait Index (DGI) has been used as a valid and reliable tool to assess balance performance in various populations. However, it has been translated into the Persian language and has shown perfect psychometric properties in the elderly population. The Persian version in Multiple Sclerosis (MS) population was validated, but its reliability has not been examined. The aim of the current study was to investigate the inter-rater reliability, test-retest reliability, and internal consistency of the Persian version of DGI in MS patients. Materials and Methods: A total of 62 participants took part in the reliability process. The sample included 51 females and 11 males. Inter-rater reliability was assessed by the agreement of the results obtained by two occupational therapists. We considered a 3-day interval for the first and second data collection. Test-retest and inter-rater reliability were measured with the Intraclass Correlation Coefficient (ICC2, 1) and internal consistency was evaluated with the Cronbach alpha. Results: The Persian version of DGI showed excellent inter-rater reliability (ICC for total score was 0.98 and ICC for the items ranged from 0.83 to 0.96) and test-retest reliability (ICC for the overall score was 0.97 and ICC for the items ranged from 0.82 to 0.96). The Cronbach alpha of the Persian version of DGI was 0.87. Conclusion: The Persian version of DGI can be used as a reliable tool for dynamic balance measurement of MS patients in clinical settings and research studies. Citation: Soltanpour H, Kalantari M, Roostaei M. Inter-rater Reliability, Test-retest Reliability, and Internal Consistency of the Persian Version of Dynamic Gait Index in Patients With Multiple Sclerosis. Journal of Modern Rehabilitation. 2018; 12(4):245-252. http://dx.
Evidence-based measurement: Which disability scale for neurologic rehabilitation?
Neurology, 2001
To compare the 10-item Barthel Index (BI), 18-item Functional Independence Measure (FIM), and 30-item Functional Independence Measure ϩ Functional Assessment Measure (FIMϩFAM) as measures of disability outcomes for neurologic rehabilitation. Methods: A total of 149 inpatients from two rehabilitation units in South England specializing in neurologic disorders were studied. Traditional psychometric methods were used to evaluate and compare acceptability (score distributions), reliability (internal consistency, intrarater reproducibility), validity (concurrent, convergent and discriminant construct), and responsiveness (standardized response mean). Results: All three rating scales satisfied recommended criteria for reliable and valid measurement of disability, and are acceptable and responsive in this study sample. The FIM and FIMϩFAM total scales are psychometrically similar measures of global disability. The BI, FIM, and FIMϩFAM motor scales are psychometrically similar measures of physical disability. The FIM and FIMϩFAM cognitive scales are psychometrically similar measures of physical disability. Conclusions: In the sample studied, the BI, FIM, FIMϩFAM have similar measurement properties, when examined using traditional psychometric analyses. Although instruments with more items and item response categories generate more qualitative information about an outcome, they may not improve its measurement. Results highlight the importance of using recognized techniques of scale construction to develop health outcome measures.
2018
Introduction: Dynamic Gait Index (DGI) has been used as a valid and reliable tool to assess balance performance in various populations. However, it has been translated into the Persian language and has shown perfect psychometric properties in the elderly population. The Persian version in Multiple Sclerosis (MS) population was validated, but its reliability has not been examined. The aim of the current study was to investigate the inter-rater reliability, test-retest reliability, and internal consistency of the Persian version of DGI in MS patients.Materials and Methods: A total of 62 participants took part in the reliability process. The sample included 51 females and 11 males. Inter-rater reliability was assessed by the agreement of the results obtained by two occupational therapists. We considered a 3-day interval for the first and second data collection. Test-retest and inter-rater reliability were measured with the Intraclass Correlation Coefficient (ICC2, 1) and internal consistency was evaluated with the Cronbach alpha.Results: The Persian version of DGI showed excellent inter-rater reliability (ICC for total score was 0.98 and ICC for the items ranged from 0.83 to 0.96) and test-retest reliability (ICC for the overall score was 0.97 and ICC for the items ranged from 0.82 to 0.96). The Cronbach alpha of the Persian version of DGI was 0.87.Conclusion: The Persian version of DGI can be used as a reliable tool for dynamic balance measurement of MS patients in clinical settings and research studies.
Physical Therapy, 2014
BackgroundThe modified Dynamic Gait Index (mDGI), developed from a person-environment model of mobility disability, measures mobility function relative to specific environmental demands. The framework for interpreting mDGI scores relative to specific environmental dimensions has not been investigated.ObjectiveThe aim of this study was to examine the person-environmental model underlying the development and interpretation of mDGI scores.DesignThis was a cross-sectional, descriptive study.MethodsThere were 794 participants in the study, including 140 controls. Out of the total study population, 239 had sustained a stroke, 140 had vestibular dysfunction, 100 had sustained a traumatic brain injury, 91 had gait abnormality, and 84 had Parkinson disease. Exploratory factor analysis was used to investigate whether mDGI scores supported the 4 environmental dimensions.ResultsFactor analysis showed that, with some exceptions, tasks loaded on 4 underlying factors, partially supporting the unde...
Disability and Rehabilitation, 2013
To examine the construct validity and inter-rater reliability of the Neurological Impairment Scale (NIS) and compare ratings by medical and multidisciplinary teams in a mixed neurorehabilitation sample. To assess its concurrent and predictive validity as a predictor of outcome and functional gains during inpatient rehabilitation. Methods: The NIS was rated in a consecutive cohort of patients (n ¼ 428) recruited from nine specialist neurorehabilitation units in London. Dimensionality and internal consistency were explored through principal components analysis with Varimax rotation. Inter-rater reliability and the relationship between NIS and functional outcome (UK Functional Assessment Measure (FIM þ FAM)) were analysed in a subsample (n ¼ 94) from one centre. Results: Factor analysis identified two principal domains (''Physical'' and ''Cognitive'') together accounting for 35% of the variance: their Cronbach's alpha values were 0.76 and 0.67, respectively. Inter-rater reliability was excellent for overall scores between doctors (ICC ¼ 0.95 (95% CI ¼ 0.91-0.97)) and acceptable between the medical and multidisciplinary team (ICC ¼ 0.92 (95% CI ¼ 0.88-0.95)). Change in NIS-physical score predicted 29% of the variance in functional gain (FIM þ FAM change). Conclusion: These findings provide the first formal evidence for the validity and reliability of the NIS as a measure of neurological impairment for use in general neuro-rehabilitation settings. Its further application and exploration are now warranted. ä Implications for Rehabilitation The extent of neurological recovery occurring during rehabilitation can make an important contribution to functional gains. In order to interpret measurement of functional outcome, we need to be able to identify changes at the level of impairment. Many of the available tools to measure severity of impairment are condition specific. The Neurological Impairment Scale (NIS) was developed for use across a broad range of disabling conditions alongside the UK FIM+FAM. This first formal examination of its psychometric properties provides evidence for its scalability, reliability and validity. The NIS has potential to provide useful information for case-mix adjustment and as a predictor of functional gain in general neurorehabilitation settings.