Dynamic Gait Index

What is a Dynamic Gait Index (DGI)?

The , also known as DGI, is an assessment developed to compute the likelihood of falling in older adults. It tests the 8 types of gait, namely:

• Gait Level Surface
• Change in Gait Speed
• Gait with Horizontal Head Turns
• Gait with Vertical Head Turns
• Gait and Pivot Turn
• Step Over Obstacles
• Stairs.

These tasks are everyday movements a client may encounter, from walking with and without obstacles to abrupt turning/stopping and even various head movements.

The test utilizes equipment such as shoeboxes, stairs, a stopwatch, and a marked walkway, and each test shouldn’t take longer than 30 minutes. As for scoring, the test uses an ordinal scale from 0-3, with 3 being the highest and 0 being the lowest. The corresponding level of function per score is as follows:

• Zero (0) = Severe Impairment
• One (1) = Moderate Impairment
• Two (2) = Mild Impairment
• Three (3) = Normal

Scoring relies on the rater’s comprehension of the provided description on the template and their observational skills. Because there are situations wherein a second slower or a tilt towards a certain side can be the basis of a higher or lower score.

By the end of the test, the rater must be able to identify the fall risk and possible challenges a client may face outside the test set-up.

How Does this Dynamic Gait Index Work?

Step One. Download the Template

Access the template above by clicking “Download Template” or search for “Dynamic Gait Index” in Carepatron’s template library.

Step Two. Prepare the Template and Equipment

Fill out the basic details on top of the form: date, patient name, age, gender, sex, patient’s signature, and your name and signature.

Afterward, prepare the following equipment you need for carrying out the test:

• Shoe box
• Two obstacles
• Stairs
• 20-foot pathway
  

It’s recommended that you read over the test to familiarize yourself with the instructions, scoring, and descriptions.

Step Three. Conduct the Test

Instruct your client to do the movements written on the template from top-to-bottom, taking short breaks in between if necessary. A test should take 20 minutes to complete.

Feel free to be on guard half a step behind your client where they can’t see you, just in case they need physical assistance.

Step Four. Compute and Interpret the Score

After every test, check off the score corresponding to the level of function based on the description provided on the template. When you’ve finished with the 8 facets, compute the total score by adding the scores obtained from the tests.

Remember to add a narrative summary of findings at the bottom. An example is: “Client’s Dynamic Gait Index (DGI) score is 14. They are at fall risk.”

Step Five. Formulate a Clinical Impression or Diagnosis

Once you’ve finished scoring and writing down your findings, you may proceed to formulate a clinical impression or diagnosis. However, it’s best that clients undergo further testing since certain disorders need complementary tests before diagnosis.

Scoring

Scoring a Dynamic Gait Index (DGI) is as simple as observing your client per test and giving them the corresponding score based on how fast or accurately they do the movement with or without assistance.

Generally, you can score a client a three (3) if they are fully capable of following instructions to the dot without delay or assistance and a zero (0) if they are unable to follow instructions or refuse due to pain. Giving a one (1) or two (2) score will depend heavily on your observational skills. You may refer to the template to see the detailed descriptions.

When to Use this Dynamic Gait Assessment?

Practitioners can use the Dynamic Gait Assessment when the client manifests disorder symptoms that affect their gait or balance and interfere with everyday activities. However, even prior to manifestation, a practitioner may conduct the assessment when the client verbalizes concerns and problems doing any of the movements in the test in a real-life setting.

Aside from those, one must only use the template and conduct the test with the following considerations:

• Environment: To reduce distractions, the practitioner must consider administering the test in a standardized testing environment such as a doctor’s office, hospital, or an outpatient/rehab clinic.
• Medical History: A practitioner may consider asking or looking over the medical history in case the template shall be used as a baseline, a progress tracker, or a point of comparison. Moreover, if the client is diagnosed with other conditioners, there may be more appropriate tests to check their gait instead.
• Client’s age: The test may be designed for older adults; however, it can be administered to anyone of any age. Considering your client’s age will make it easier for you to filter out conditioners and disorders a client may have.

Who is this DGI for?

Any clinician or professional can administer the Dynamic Gait Index (DGI). However, the following practitioners may benefit the most from using the template:

• General Practitioner
• Physiatrist
• Rehabilitation Nurse
• Physical and Occupational Therapist
• Physiotherapist
• Neurologist

The template is made specifically for the practitioners mentioned above because they are the ones who specialize or are involved in diagnosing disorders related to balance, gait, etc., formulating a treatment plan, or ensuring clients follow the rehabilitation program provided to them for the following conditions:

• Stroke
• Parkinson’s Disease
• Multiple Sclerosis
• Brain Injury

Others mentioned above, such as the physiatrist and physical and occupational therapist may find this template useful because they work with the type of clients the DGI test is designed for - older adults and patients in geriatric care.

Additionally, audiologists and otolaryngologists can also use this template since clients with gait concerns may have vestibular problems. However, they are encouraged to utilize the modified DGI, the Functional Gait Assessment, instead because these tests have movements added to aid in the diagnosis of vestibular disorder.

Benefits of Free Dynamic Gait Index

Establish Baseline

Practitioners who have new clients who haven’t been diagnosed or aren’t in the middle of a treatment plan or program can use the template to establish a baseline for comparison post-test and post-intervention.

Provides Insight

Should the client be in the middle of a treatment or program, practitioners can also use this template to check if the intervention is helping in reducing the client’s risk of falling.

Improved Self-Awareness

Clients who haven’t done the test before can learn more about themselves through this test and identify their physical limits and capabilities.

Quick Screening

Since this test can be accomplished in around 15-20 minutes, it’s an ideal test a practitioner can conduct during a consenting client’s first session. That way, they may proceed with the next steps to handling their concerns or alleviating their pain as soon as possible.

Create Individualized Treatment Plans

It is expected that clients will have varying results on a standardized test. Hence, creating a unique treatment plan to address specific problem areas is best. This test can be a reliable resource when designing a program or deciding a treatment plan since it pinpoints which movements need intervention.