CHAPTER 18: DYNAMIC GAIT INDEX (DGI)

Description

The Dynamic Gait Index (DGI), by Shumway-Cook et al. (1995), is designed to assess dynamic postural control in older adults and is used to quantify walking ability and fall risk as well as determine changes in gait and balance throughout the therapeutic process. Validated among several conditions such as multiple sclerosis, stroke, Parkinson’s disease, older adults with dizziness or balance problems, and relatively healthy independent older adults, the DGI has 8 tasks and includes such items as stepping over an obstacle where the subject is asked to walk at their normal speed up to and over a shoebox, as well as gait with horizontal head turn where the person must look both left and right while walking for a time (Herman, Inbar-Borovsky, Brozgol, Giladi, & Hausdorff, 2009). A newly modified version also exists with slight changes to the original 8 items as well as an expanded scoring system for better sensitivity. Both measures are based on a person-environment model of mobility which argues that particular environmental demands must be met in order to achieve functional performance, which can be categorized into one of several dimensions representing those external demands that have to be met for an individual to be mobile within their environment, such as the ability to navigate successfully through existing ambient conditions. Performance of both the original and modified versions are based on a combination of gait performance (GP), level of assistance (LOA), and time to complete the activity (T). Scoring of the original DGI uses a single 4-point ordinal scale for each item (range 0 to 3); however, for the mDGI, separate scores are applied to performance relative to (1) the time it takes to complete each task, (2) LOA needed, which uses a 3-point scale, and (3) GP, which uses a 4-point scale that differs slightly for each task. Lower scores are indicative of decreased performance. Although, the DGI requires some set up, once done it can be completed in less than 15 minutes.

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