Impact of strength and balance on Functional Gait Assessment performance in older adults

Background: The Functional Gait Assessment (FGA) evaluates postural stability in gait and predicts fall risk in older adults. Individual tasks within the FGA consider aspects of mobility assumed to require strength and/or balance to complete. Identifying how quantitative measures of strength and balance relate to FGA performance would allow for more targeted interventions based on one's pattern of performance on different tasks. Research Question: Is performance on the FGA (total score and individual task scores) related to measures of strength and balance in healthy older adults? Methods: In a cross-sectional study, healthy older adults (N = 46) were evaluated with the FGA, measures of knee extensor strength, and balance (static stance and weight shifting) (N = 46). Correlational analyses were performed between FGA scores (total and individual) and measures of strength and balance. Results: Total FGA performance was positively correlated with knee extensor strength (maximum torque and rate of torque development). Individual FGA tasks of walking backwards (task 9) and stair climbing (task 10) had the highest correlations with strength measures. Total FGA performance was correlated with reduced postural sway in static balance tasks, but not with balance performance on the weight shifting tasks. The individual FGA task that challenged proprioceptive (task 7) inputs for balance was associated with static balance. Significance: The total FGA score is related to domains of strength and static balance. The results indicate that the FGA can be influenced by reduced strength and balance. The pattern of performance on individual FGA tasks may indicate whether reduced postural stability in gait is related to deficits in strength or balance domains in this older population.