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Cited by 90Stroke Rehabilitation and RecoveryBalance, Gait, and Falls PreventionHealth Education and Validation

Development and testing of the Gait Assessment and Intervention Tool (G.A.I.T.): A measure of coordinated gait components

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Daly, J.J., Nethery, J., McCabe, J.P., Brenner, I., Rogers, J., Gansen, J., Butler, K., Burdsall, R. +2 more·2009·Journal of Neuroscience Methods
DOI 10.1016/j.jneumeth.2008.12.016
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Abstract

Recent neuroscience methods have provided the basis upon which to develop effective gait training methods for recovery of the coordinated components of gait after neural injury. We determined that there was not an existing observational measure that was, at once, adequately comprehensive, scored in an objectively-based manner, and capable of assessing incremental improvements in the coordinated components of gait. Therefore, the purpose of this work was to use content valid procedures in order to develop a relatively inexpensive, more comprehensive measure, scored with an objectively-based system, capable of incrementally scoring improvements in given items, and that was both reliable and capable of discriminating treatment response for those who had a stroke. Eight neurorehabilitation specialists developed criteria for the gait measure, item content, and scoring method. In subjects following stroke (>12 months), the new measure was tested for intra- and inter-rater reliability using the Intraclass Correlation Coefficient; capability to detect treatment response using Wilcoxon Signed Ranks Test; and discrimination between treatment groups, using the Plum Ordinal Regression. The Gait Assessment and Intervention Tool (G.A.I.T.) is a 31-item measure of the coordinated movement components of gait and associated gait deficits. It exhibited the following advantages: comprehensive, objective-based scoring method, incremental measurement of improvement within given items. The G.A.I.T. had good intra- and inter-rater reliability (ICC=.98, p=.0001, 95% CI=.95, .99; ICC=.83, p=.007, 95% CI=.32, .96, respectively. The inexperienced clinician who had training, had an inter-rater reliability with an experienced rater of ICC=.99 (p=.0001, CI=.97, .999). The G.A.I.T. detected improvement in response to gait training for two types of interventions: comprehensive gait training (z=-2.93, p=.003); and comprehensive gait training plus functional electrical stimulation (FES; z=-3.3, p=.001). The G.A.I.T. was capable of discriminating between two gait training interventions, showing an additive advantage of FES to otherwise comparable comprehensive gait training (parameter estimate=1.72, p=.021; CI, .25, 3.1).

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Authors
Daly, J. J., Nethery, J., McCabe, J. P., Brenner, I., Rogers, J., Gansen, J., Butler, K., Burdsall, R., Roenigk, K., & Holcomb, J.
Affiliations
  • Louis Stokes Cleveland VA Medical Center (US)
  • Cleveland State University (US)
Corresponding author
Daly, J.J.
ORCID
Venue
Journal of Neuroscience Methods
Publisher
Elsevier BV
Published
2009-04
Volume
178
Issue
2
Pages
334-339
ISSN
0165-0270 (ISSN-L)
DOI
10.1016/j.jneumeth.2008.12.016
OpenAlex
W1975430804
Cited by
90
References
34
Citations by year
2026: 7 · 2025: 14 · 2024: 3 · 2023: 12 · 2022: 8 · 2021: 10 · 2020: 9 · 2019: 7 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 5 · 2014: 1 · 2013: 3
FWCI
1.07
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Neuroscience Methods (publishedVersion)
  • PubMed (publishedVersion)
  • EngagedScholarship @ Cleveland State University (Cleveland State University) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Social Sciences › Education › Health Education and Validation
Keywords
gait analysis, gait coordination, stroke, gait training, functional electrical stimulation, neurorehabilitation, rating scale development, inter-rater reliability, treatment response, gait deficits
MeSH terms
Biomechanical Phenomena, Electric Stimulation Therapy, Gait, Humans, Leg, Movement Disorders, Severity of Illness Index, Reproducibility of Results, Stroke

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