Does hands-on guarding influence performance on the functional gait assessment?

Review written by Dr Mariana Wingood info

Key Points

  1. Hands-on guarding does not significantly influence performance on the Functional Gait Assessment when the guarding is provided by an experienced physical therapist and the participant is a community-dwelling older adult.
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When performing balance and fall risk assessments, clinicians challenge their patients’ balance to the point where they lose their balance but do not fall. To minimize risk, clinicians tend to use gait belts and appropriate guarding techniques. Recently, the use of gait belts and guarding techniques has come under question as research has identified that external contact, even if just a passive light touch from a finger, can impact postural control during quiet stance (1), when receiving an unexpected perturbation (2), and while walking (3).

Due to these findings and fear of impacting the assessment or intervention, some clinicians have decided to provide minimal to no guarding. However, no studies have examined the impact of touch when the intent is not to facilitate balance control but rather to prevent a fall to the ground. Therefore the conclusion drawn by some clinicians - that providing contact guard assist impacts the results of outcome measures - may not be true.

The authors of this study decided to examine the effect of hands-on guarding when the intent of guarding is to prevent a fall in community-dwelling older adults. The authors hypothesized that (1) there would not be a significant difference in scores of the Functional Gait Assessment (FGA) when comparing contact guarding (CG) with standby guarding (SG), and (2) participants would not perceive a difference between the two guarding methods.

Even light external contact can impact postural control during quiet stance, when receiving an unexpected perturbation, and while walking.
Patients tend to have a reduction in fear of falling by providing a sense of security through guarding.



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