Functional Gait Assessment (FGA)
Form
- Gait level surface
- Changing gait speed
- Gait with Horizontal Head Turns
- Gait with Vertical Head Turns
- Pivot Turn
- Step Over Obstacle
- Narrow Base of Support
- Eyes Closed
- Backwards
- Stairs
1 Level Gait
Instructions: Walk at your normal speed from here to the next mark (6m [20 ft]).
| Score | Level | Criteria |
|---|---|---|
| 3 | Normal | Walks 6 m (20 ft) in less than 5.5 seconds, no assistive devices, good speed, no evidence for imbalance, normal gait pattern, deviates no more than 15.24 cm (6 in) outside of the 30.48-cm (12-in) walkway width |
| 2 | Mild | 6m (20 ft) in <7sec but >5.5 seconds uses assistive device, slower speed, mild gait deviations, or deviates 15.24 – 25.4 cm (6 – 10 in) outside of the 30.48-cm (12-in) walkway width |
| 1 | Moderate | Walks 6 m (20 ft), slow speed, abnormal gait pattern, evidence for imbalance, or deviates 25.4 – 38.1 cm (10 – 15 in) outside of the 30.48-cm (12-in) walkway width. Requires more than 7 seconds to ambulate 6 m (20 ft) |
| 0 | Severe impairment | Cannot walk 6 m (20 ft) without assistance, severe gait deviations or imbalance, deviates greater than 38.1 cm (15 in) outside of the 30.48-cm (12-in) walkway width or reaches and touches the wall |
Item 1 Score: Not tested
2 Changing Gait Speed
Instructions: Begin walking at your normal pace (for 1.5 m [5 ft]). When I tell you “go,” walk as fast as you can (for 1.5 m [5 ft]). When I tell you “slow,” walk as slowly as you can (for 1.5 m [5 ft]).
| Score | Level | Criteria |
|---|---|---|
| 3 | Normal | Able to smoothly change walking speed without loss of balance or gait deviation. Shows a significant difference in walking speeds between normal, fast, and slow speeds. Deviates no more than 15.24 cm (6 in) outside of the 30.48-cm (12-in) walkway width. |
| 2 | Mild | Is able to change speed but demonstrates mild gait deviations, deviates 15.24 – 25.4 cm (6 – 10 in) outside of the 30.48-cm (12-in) walkway width, or no gait deviations but unable to achieve a significant change in velocity, or uses an assistive device. |
| 1 | Moderate | Makes only minor adjustments to walking speed, or accomplishes a change in speed with significant gait deviations, deviates 25.4 – 38.1 cm (10 – 15 in) outside the 30.48-cm (12-in) walkway width, or changes speed but loses balance but is able to recover and continue walking. |
| 0 | Severe | Cannot change speeds, deviates greater than 38.1 cm (15 in) outside 30.48-cm (12-in) walkway width, or loses balance and has to reach for wall or be caught. |
Item 2 Score: Not tested
3 Gait with Horizontal Head Turns
Instructions: Walk from here to the next mark 6 m (20 ft) away. Begin walking at your normal pace. Keep walking straight; after 3 steps, turn your head to the right and keep walking straight while looking to the right. After 3 more steps, turn your head to the left and keep walking straight while looking left. Continue alternating looking right and left every 3 steps until you have completed 2 repetitions in each direction.
| Score | Level | Criteria |
|---|---|---|
| 3 | Normal | Performs head turns smoothly with no change in gait. Deviates no more than 15.24 cm (6 in) outside 30.48-cm (12-in) walkway width. |
| 2 | Mild impairment | Performs head turns smoothly with slight change in gait velocity (eg, minor disruption to smooth gait path), deviates 15.24 – 25.4 cm (6 – 10 in) outside 30.48-cm (12-in) walkway width, or uses an assistive device. |
| 1 | Moderate impairment | Performs head turns with moderate change in gait velocity, slows down, deviates 25.4 – 38.1 cm (10 – 15 in) outside 30.48-cm (12-in) walkway width but recovers, can continue to walk. |
| 0 | Severe impairment | Performs task with severe disruption of gait (eg, staggers 38.1 cm [15 in] outside 30.48-cm (12-in) walkway width, loses balance, stops, or reaches for wall). |
Item 3 Score: Not tested
4 Gait with Vertical Head Turns
Instructions: Walk from here to the next mark (6 m [20 ft]). Begin walking at your normal pace. Keep walking straight; after 3 steps, tip your head up and keep walking straight while looking up. After 3 more steps, tip your head down, keep walking straight while looking down. Continue alternating looking up and down every 3 steps until you have completed 2 repetitions in each direction.
| Score | Impairment | Criteria |
|---|---|---|
| 3 | Normal | Performs head turns with no change in gait. Deviates no more than 15.24 cm (6 in) outside 30.48-cm (12-in) walkway width. |
| 2 | Mild | Performs task with slight change in gait velocity (eg, minor disruption to smooth gait path), deviates 15.24–25.4 cm (6–10 in) outside 30.48-cm (12-in) walkway width or uses an assistive device. |
| 1 | Moderate | Performs task with moderate change in gait velocity, slows down, deviates 25.4–38.1 cm (10–15 in) outside 30.48-cm (12-in) walkway width but recovers, can continue to walk. |
| 0 | Severe | Performs task with severe disruption of gait (eg, staggers 38.1 cm [15 in] outside 30.48-cm (12-in) walkway width, loses balance, stops, or reaches for wall). |
Item 4 Score: Not tested
5 Pivot Turn
Instructions: Begin with walking at your normal pace. When I tell you, “turn and stop,” turn as quickly as you can to face the opposite direction and stop.
| Score | Level | Criteria |
|---|---|---|
| 3 | Normal | Pivot turns safely within 3 seconds and stops quickly with no loss of balance. |
| 2 | Mild | Pivot turns safely in more than 3 seconds and stops with no loss of balance, or pivot turns safely within 3 seconds and stops with mild imbalance, requires small steps to catch balance. |
| 1 | Moderate | Turns slowly, requires verbal cueing, or requires several small steps to catch balance following turn and stop. |
| 0 | Severe | Cannot turn safely, requires assistance to turn and stop. |
Item 5 Score: Not tested
6 Step Over Obstacle
Instructions: Begin walking at your normal speed. When you come to the shoe box, step over it, not around it, and keep walking.
| Score | Impairment | Criteria |
|---|---|---|
| 3 | Normal | Is able to step over 2 stacked shoe boxes taped together (22.86 cm [9 in] total height) without changing gait speed; no evidence of imbalance. |
| 2 | Mild | Is able to step over one shoe box (11.43 cm [4.5 in] total height) without changing gait speed; no evidence of imbalance. |
| 1 | Moderate | Is able to step over one shoe box (11.43 cm [4.5 in] total height) but must slow down and adjust steps to clear box safely. May require verbal cueing. |
| 0 | Severe | Cannot perform without assistance. |
Item 6 Score: Not tested
7 Narrow Base of Support
Instructions: Walk on the floor with arms folded across the chest, feet aligned heel to toe in tandem for a distance of 3.6 m [12 ft]. The number of steps taken in a straight line are counted for a maximum of 10 steps. Grading: Mark the highest category that applies.
| Score | Level | Criteria |
|---|---|---|
| 3 | Normal | Is able to ambulate for 10 steps heel to toe with no staggering. |
| 2 | Mild | Ambulates 7–9 steps. |
| 1 | Moderate | Ambulates 4–7 steps. |
| 0 | Severe | Ambulates less than 4 steps heel to toe or cannot perform without assistance. |
Item 7 Score: Not tested
8 Eyes Closed
Instructions: Walk at your normal speed from here to the next mark (6 m [20 ft]) with your eyes closed. Grading: Mark the highest category that applies.
| Score | Impairment | Criteria |
|---|---|---|
| 3 | Normal | Walks 6 m (20 ft), no assistive devices, good speed, no evidence of imbalance, normal gait pattern, deviates no more than 15.24 cm (6 in) outside 30.48-cm (12-in) walkway width. Ambulates 6 m (20 ft) in less than 7 seconds. |
| 2 | Mild | Walks 6 m (20 ft), uses assistive device, slower speed, mild gait deviations, deviates 15.24 – 25.4 cm (6 – 10 in) outside 30.48-cm (12-in) walkway width. Ambulates 6 m (20 ft) in less than 9 seconds but greater than 7 seconds. |
| 1 | Moderate | Walks 6 m (20 ft), slow speed, abnormal gait pattern, evidence for imbalance, deviates 25.4 – 38.1 cm (10 – 15 in) outside 30.48-cm (12-in) walkway width. Requires more than 9 seconds to ambulate 6 m (20 ft). |
| 0 | Severe | Cannot walk 6 m (20 ft) without assistance, severe gait deviations or imbalance, deviates greater than 38.1 cm (15 in) outside 30.48-cm (12-in) walkway width or will not attempt task. |
Item 8 Score: Not tested
9 Backwards
Instructions: Walk backwards until I tell you to stop. Grading: Mark the highest category that applies.
| Score | Impairment | Criteria |
|---|---|---|
| 3 | Normal | Walks 6m (20 ft), no assistive devices, good speed, no evidence for imbalance, normal gait pattern, deviates no more than 15.24 cm (6 in) outside 30.48-cm (12-in) walkway width. |
| 2 | Mild | Walks 6 m (20 ft), uses assistive device, slower speed, mild gait deviations, deviates 15.24 – 25.4 cm (6 – 10 in) outside 30.48-cm (12-in) walkway width. |
| 1 | Moderate | Walks 6 m (20 ft), slow speed, abnormal gait pattern, evidence for imbalance, deviates 25.4 – 38.1 cm (10 – 15 in) outside 30.48-cm (12-in) walkway width. |
| 0 | Severe | Cannot walk 6 m (20 ft) without assistance, severe gait deviations or imbalance, deviates greater than 38.1 cm (15 in) outside 30.48-cm (12-in) walkway width or will not attempt task. |
Item 9 Score: Not tested
10 Stairs
Instructions: Walk up these stairs as you would at home (ie, using the rail if necessary). At the top turn around and walk down.
| Score | Level | Criteria |
|---|---|---|
| 3 | Normal | Alternating feet, no rail. |
| 2 | Mild | Alternating feet, must use rail. |
| 1 | Moderate | Two feet to a stair; must use rail. |
| 0 | Severe | Cannot do safely. |
Item 10 Score: Not tested
Results
Item 1 Score: Not tested
Item 2 Score: Not tested
Item 3 Score: Not tested
Item 4 Score: Not tested
Item 5 Score: Not tested
Item 6 Score: Not tested
Item 7 Score: Not tested
Item 8 Score: Not tested
Item 9 Score: Not tested
Item 10 Score: Not tested
Total: 0