Forsberg Anette, Andreasson Malin, Nilsagård Ylva
Int J MS Care. 2017 Mar-Apr;19(2):66-72. doi: 10.7224/1537-2073.2015-061.
Assessments of balance and walking are often performed in rehabilitation of people with multiple sclerosis (MS). The Functional Gait Assessment (FGA) is a test of walking balance including challenging items such as walking with a narrow base of support, with eyes closed, and backward. The aim was to investigate the validity (concurrent, discriminant, and known-groups) and sensitivity to change of the modified FGA in ambulatory individuals with MS.
A convenience sample of 87 individuals with MS was included (mean age, 54 years; 79% women). Concurrent and discriminant validity was investigated using tests of dynamic balance and the Multiple Sclerosis Walking Scale and Multiple Sclerosis Impact Scale (MSIS). Known-groups validity was investigated with self-reported number of falls and use of walking devices. Sensitivity to change was investigated with data from a group balance training study.
The median FGA score was 15 (range, 1-26). Concurrent validity with tests of dynamic balance was moderate to strong, with the Timed Up and Go test having the highest correlation coefficient (rho = -0.74). Discriminant validity was shown with a low correlation coefficient with the MSIS psychological subscale (rho = 0.14). The FGA scores differed significantly for users of walking devices versus nonusers but not for reported falls. Sensitivity to change was moderate to low.
The FGA is a valid measure of balance during walking in people with MS, but further investigation is required for the ability to detect people at risk for falls.
在多发性硬化症（MS）患者的康复过程中，常对平衡能力和步行能力进行评估。功能性步态评估（FGA）是一项步行平衡测试，包括一些具有挑战性的项目，如在狭窄支撑面行走、闭眼行走和向后行走。目的是研究改良FGA在MS门诊患者中的效度（同时效度、区分效度和已知组效度）以及对变化的敏感性。
纳入87例MS患者的便利样本（平均年龄54岁；79%为女性）。使用动态平衡测试、多发性硬化症步行量表和多发性硬化症影响量表（MSIS）来研究同时效度和区分效度。通过自我报告的跌倒次数和步行辅助器具的使用情况来研究已知组效度。利用一组平衡训练研究的数据来研究对变化的敏感性。
FGA评分中位数为15（范围1 - 26）。与动态平衡测试的同时效度为中度至高度，“起立行走”测试的相关系数最高（rho = -0.74）。与MSIS心理亚量表的相关系数较低，显示出区分效度（rho = 0.14）。使用步行辅助器具者与未使用者的FGA评分有显著差异，但跌倒报告情况无差异。对变化的敏感性为中度至低度。
FGA是MS患者步行时平衡能力的有效测量方法，但在检测跌倒风险人群方面的能力还需要进一步研究。
