Abstract
Background and Purpose: The Dynamic Gait Index (DGI) was developed as a tool to identify the ability of an individual to modify gait in response to various conditions, including: level walking, changes in gait speed, walking with head turns in the horizontal and vertical direction, stopping and turning, stepping over and around obstacles, and ascending and descending stairs. The DGI has been used to assess adaptation of gait in a variety of conditions; however, there has not been sufficient research on the use of the DGI to examine a lower extremity amputee's ability to adapt his/her gait to changes in task demand. This study seeks to determine the inter-rater reliability of the dynamic gait index when used to assess an individual with a lower extremity amputation. Methods: A volunteer between ages 50-65 was recruited and videotaped performing the tasks on the DGI under the supervision of a licensed physical therapist. The video was shown to a gait panel, who established a true score using the DGI. Physical therapists were recruited as subjects to rate the performance of the volunteer on the video with the DGI. Scores were then analyzed for agreement using the Fleiss' kappa and the interclass correlation. Results: The raw score of absolute agreement was 39 out of a possibility of 80 (48.75% agreement). Fleiss' kappa statistic (-0.0347) was calculated using the ratio between the degree of agreement above chance actually found in the study (-0.0172) and the degree of agreement above what is expected by chance (0.4953). The ICC was calculated to be 0.18 (95% confidence interval: .043-.476). Conclusion: According to the results of this study, the DGI may not be recommended for the assessment of a lower extremity amputee's ability to adapt his/her gait to changes in task demand, which may contribute to falls risk.