Physiotherapists’ understanding and assessment of gait stability: a qualitative study

Maintaining a stable gait is required to safely navigate our environments, however, little is known about what physiotherapists consider when determining an older adult’s gait stability. Thus, the objective of this study was to describe how physiotherapists understand and assess gait stability. Twenty-six Canadian registered physiotherapists with clinical experience in gerontology participated in a semi-structured interview. Physiotherapists were asked about their understanding of gait stability and shared their approach to assessment using videos of older adults walking. Physiotherapists then used a standardized definition of gait stability and re-assessed gait stability. Interviews were analyzed using conventional and summative content analysis. There was no common understanding of gait stability amongst participants, and their assessments included these features: managing disturbances to balance, movement of the trunk and arms, gait mechanics, level of independence, confidence, cognition and insight and medical conditions. Upon receiving a standardized definition of gait stability, participants more consistently discussed how gait impairments impacted resilience to perturbations. It is important for physiotherapists to gain familiarity with how to assess gait stability. This study highlights the need for translating gait stability knowledge into practice. Addressing gait stability in clinical practice may help physiotherapists better support patients in being able to safely navigate home and community environments.Some physiotherapists are unfamiliar with the term gait stability and there was variability in their gait stability assessments.Physiotherapists should consider using the six features identified in this study as a basis for understanding and assessing gait stability in their clinical practice. Addressing gait stability in clinical practice may help physiotherapists better support patients in being able to safely navigate home and community environments. Some physiotherapists are unfamiliar with the term gait stability and there was variability in their gait stability assessments. Physiotherapists should consider using the six features identified in this study as a basis for understanding and assessing gait stability in their clinical practice.