Translation, Cross-Cultural Adaptation, and Contribution to the Validation of the Portuguese Version of the GAIT

Isabel Baleia; Hugo Santos; Rita Brandão; Patrícia Almeida; Elisabete Martins

doi:10.62741/ahrj.v1i3.28

Authors

Isabel Baleia Escola Superior de Saúde do Alcoitão https://orcid.org/0000-0002-9324-9811
Hugo Santos Escola Superior de Saúde do Alcoitão
Rita Brandão Escola Superior de Saúde do Alcoitão https://orcid.org/0000-0002-0617-7638
Patrícia Almeida Escola Superior de Saúde do Alcoitão https://orcid.org/0000-0003-2081-3976
Elisabete Martins Escola Superior de Saúde do Alcoitão https://orcid.org/0000-0002-3101-2456

DOI:

https://doi.org/10.62741/ahrj.v1i3.28

Abstract

Introduction: The Gait Assessment and Intervention Tool (GAIT) is an observational gait scale designed to identify and evaluate gait pattern alterations in individuals with Stroke.

Objective: To translate, culturally adapt, and validate the European Portuguese version of the GAIT, ensuring its applicability in clinical practice and research.

Material and Methods: The study was conducted in two phases: (1) Translation and cultural adaptation, following international guidelines, including translation, back-translation, review by a panel of 11 experts and pre-testing; (2) Content validation, assessed by a panel of nine experts using the Content Validity Index (CVI).

Results: The final Portuguese version of the GAIT achieved 100% agreement among experts in the pre-test phase. In content validation, 30 out of 31 items were rated as "very relevant" or "quite relevant" (I-CVI ≥ 0.87), resulting in an S-CVI of 0.996, indicating excellent content validity.

Discussion: The Portuguese version of the GAIT demonstrated conceptual equivalence with the original scale and strong content validity. These findings suggest that the GAIT is a reliable and valuable tool for post-stroke gait assessment, supporting the identification of specific gait impairments and the implementation of targeted interventions.

Conclusion: The high content validity scores and strong expert agreement support the use of the Portuguese GAIT in clinical practice and research. Future studies should evaluate its inter- and intra-rater reliability and explore its integration with digital technologies for gait analysis.

References

Di Biase L, Di Santo A, Caminiti ML, et al. Gait analysis in Parkinson’s disease: an overview of the most accurate markers for diagnosis and symptoms monitoring. Sensors (Basel).

;20(12):3529. doi:10.3390/s20123529 DOI: https://doi.org/10.3390/s20123529

Selves C, Stoquart G, Lejeune T. Gait rehabilitation after stroke: review of the evidence of predictors, clinical outcomes and timing for interventions. Acta Neurol Belg. 2020;120(4):783-790.

doi:10.1007/s13760-020-01320-7 DOI: https://doi.org/10.1007/s13760-020-01320-7

Mohan DM, Khandoker AH, Wasti SA, Ismail Ibrahim Ismail Alali S, Jelinek HF, Khalaf K. Assessment methods of poststroke gait: a scoping review of technology-driven approaches to gait characterization and analysis. Front Neurol. 2021;12:650024. doi:10.3389/fneur.2021.650024 DOI: https://doi.org/10.3389/fneur.2021.650024

Hyun SJ, Lee J, Lee BH. The effects of sit-to-stand training combined with real-time visual feedback on strength, balance, gait ability, and quality of life in patients with stroke: a randomized controlled trial. Int J Environ Res Public Health. 2021;18(22):12229. doi:10.3390/ijerph182212229 DOI: https://doi.org/10.3390/ijerph182212229

Kim H, Kim YH, Kim SJ, Choi MT. Pathological gait clustering in post-stroke patients using motion capture data. Gait Posture. 2022;94:210-216. doi:10.1016/j.gaitpost.2022.03.007 DOI: https://doi.org/10.1016/j.gaitpost.2022.03.007

Beck Jepsen D, Robinson K, Ogliari G, et al. Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility. BMC Geriatr. 2022;22(1):615. doi:10.1186/s12877-022-03271-5 DOI: https://doi.org/10.1186/s12877-022-03271-5

Daly JJ, Nethery J, McCabe JP, et al. Development and testing of the Gait Assessment and Intervention Tool (GAIT): a measure of coordinated gait components. J Neurosci Methods. 2009;178(2):334-339. doi:10.1016/j.jneumeth.2008.12.016doi:10.1016/j.jneumeth.2008.12.016 DOI: https://doi.org/10.1016/j.jneumeth.2008.12.016

Ferrarello F, Bianchi VAM, Baccini M, et al. Tools for observational

gait analysis in patients with stroke: a systematic review.

Phys Ther. 2013;93(12):1673-1685. doi:10.2522/ptj.20120344 DOI: https://doi.org/10.2522/ptj.20120344

Molina-Rueda F, Carratalá-Tejada M, Cano De La Cuerda R, Alguacil-Diego IM, Miangolarra Page JC, Cuesta-Gómez A. Examination of the reliability of Gait Assessment and Intervention Tool in patients with a stroke. Int J Rehabil Res. 2018;41(1):84-86. doi:10.1097/MRR.0000000000000264 DOI: https://doi.org/10.1097/MRR.0000000000000264

Gor-García-Fogeda MD, Cano-de-la-Cuerda R, Daly JJ, Molina-Rueda F. Spanish cross-cultural adaptation of the Gait Assessment and Intervention Tool. PM R. 2019;11(9):954-962. doi:10.1002/pmrj.12054 DOI: https://doi.org/10.1002/pmrj.12054

Saengsuwan J, Sirasaporn P. Validity and reliability of the Thai version of the Gait Assessment and Intervention Tool (GAIT). Stroke Res Treat. 2020;2020:1710534. doi:10.1155/2020/1710534 DOI: https://doi.org/10.1155/2020/1710534

Zimbelman J, Daly JJ, Roenigk KL, Butler K, Burdsall R, Holcomb JP. Capability of 2 gait measures for detecting response to gait training in stroke survivors: Gait Assessment and Intervention Tool and the Tinetti Gait Scale. Arch Phys Med Rehabil. 2012;93(1):129-136. doi:10.1016/j.apmr.2011.08.011 DOI: https://doi.org/10.1016/j.apmr.2011.08.011

Gor-García-Fogeda MD, Cano De La Cuerda R, Carratalá Tejada M, Alguacil-Diego IM, Molina-Rueda F. Observational gait assessments in people with neurological disorders: a systematic review. Arch Phys Med Rehabil. 2016;97(1):131-140. doi:10.1016/j.apmr.2015.07.018 DOI: https://doi.org/10.1016/j.apmr.2015.07.018

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-3191. doi:10.1097/00007632-200012150-00014 DOI: https://doi.org/10.1097/00007632-200012150-00014

Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737-745. doi:10.1016/j.jclinepi.2010.02.006 DOI: https://doi.org/10.1016/j.jclinepi.2010.02.006

Wild D, Grove A, Martin M, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005;8(2):94-104. doi:10.1111/j.1524-4733.2005.04054.x DOI: https://doi.org/10.1111/j.1524-4733.2005.04054.x

Gilbert GE, Prion S. Making sense of methods and measurement: Lawshe’s content validity index. Clin Simul Nurs. 2016;12(12):530-531. doi:10.1016/j.ecns.2016.08.002 DOI: https://doi.org/10.1016/j.ecns.2016.08.002

Polit DF, Beck CT. The content validity index: Are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-497. doi:10.1002/nur.20147 DOI: https://doi.org/10.1002/nur.20147

Fermanian J. Validation des échelles d’évaluation en médecine physique et de réadaptation: comment apprécier correctement leurs qualités psychométriques. Ann Readapt Med Phys. 2005;48(6):281-287. doi:10.1016/j.annrmp.2005.04.004 DOI: https://doi.org/10.1016/j.annrmp.2005.04.004

Yusoff MSB. ABC of content validation and content validity index calculation. Educ Med J. 2019;11(2):49-54. doi:10.21315/eimj2019.11.2.6 DOI: https://doi.org/10.21315/eimj2019.11.2.6

Ferrarello F, Bianchi VA, Baccini M, et al. Tools for observational gait analysis in patients with stroke: a systematic review. PM R. 2013;5(9):806-823. doi:10.1016/j.pmrj.2013.03.013 DOI: https://doi.org/10.1016/j.pmrj.2013.03.013