Article

OBJECTIVE: To characterize the performance of 2 observational gait measures, the
Tinetti Gait Scale (TGS) and the Gait Assessment and Intervention Tool
(G.A.I.T.), in identifying improvement in gait in response to gait training.
DESIGN: In secondary analysis from a larger study of multimodal gait training for
stroke survivors, we measured gait at pre-, mid-, and posttreatment according to
G.A.I.T. and TGS, assessing their capability to capture recovery of coordinated
gait components. SETTING: Large medical center. PARTICIPANTS: Cohort of stroke
survivors (N=44) greater than 6 months after stroke. INTERVENTIONS: All subjects
received 48 sessions of a multimodal gait-training protocol. Treatment consisted
of 1.5 hours per session, 4 sessions per week for 12 weeks, receiving these 3
treatment aspects: (1) coordination exercise, (2) body weight-supported treadmill
training, and (3) overground gait training, with 46% of subjects receiving
functional electrical stimulation. MAIN OUTCOME MEASURES: All subjects were
evaluated with the G.A.I.T. and TGS before and after completing the 48-session
intervention. An additional evaluation was performed at midtreatment (after
session 24). RESULTS: For the total subject sample, there were significant
pre-/post-, pre-/mid-, and mid-/posttreatment gains for both the G.A.I.T. and the
TGS. According to the G.A.I.T., 40 subjects (91%) showed improved scores, 2 (4%)
no change, and 2 (4%) a worsening score. According to the TGS, only 26 subjects
(59%) showed improved scores, 16 (36%) no change, and 1 (2%) a worsening score.
For 1 treatment group of chronic stroke survivors, the TGS failed to identify a
significant treatment response to gait training, whereas the G.A.I.T. measure was
successful. CONCLUSIONS: The G.A.I.T. is more sensitive than the TGS for
individual patients and group treatment response in identifying recovery of
volitional control of gait components in response to gait training.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS