Enhanced Gait Variability Index in Neurological and Geriatric Rehabilitation: A Scoping Review.
The eGVI shows the most consistent evidence in Parkinson's disease but is not yet ready for standalone clinical use.
Protocols vary widely across studies and the single reference score has not been validated for the populations using it.
Key findings
1Seven of the 18 included studies examined Parkinson's disease, where the eGVI showed sensitivity to levodopa effects, fall frequency, and deep-brain stimulation response. Evidence in stroke, degenerative cervical myelopathy, and other conditions is sparse, and the review concludes the measure is most informative in PD.
2Walking protocols differed substantially across the 18 studies in equipment (Zeno, GAITRite, motion capture), number of trials (one to five), footwear, assistive-device use, and task conditions, making it impossible to compare scores directly between studies.
3All 18 studies compared eGVI scores against a single normative reference in which 100 represents typical gait variability with a standard deviation of 10, derived from healthy adults aged approximately 12 to 62 years. No study in the review validated this reference for the neurological or older-adult populations to which it was applied.
Still to come
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 18 studies met inclusion criteria, and Parkinson's disease accounted for 7 of them, so the evidence base is small and skewed toward one diagnosis. Substantial heterogeneity in study design, gait assessment protocols, instrumentation, and data processing prevented direct comparison or quantitative synthesis across studies. Most included studies were conducted in controlled laboratory settings, so it is unclear how well the eGVI reflects functional mobility in daily-life conditions. No formal critical appraisal of the included studies was conducted, consistent with scoping review methodology but limiting the ability to judge individual study quality. Only English-language, peer-reviewed studies were included, which may introduce language and publication bias. The single normative reference (healthy adults aged 12 to 62) has not been validated for any of the clinical populations in the review, and no age-, gender-, or condition-specific thresholds exist.
Declared interests
The authors received no financial support and declared no potential conflicts of interest.
The easy way to misread this
Do not interpret an eGVI score against the 100-point reference as a diagnosis of abnormality in your patient. The reference group was healthy adults aged approximately 12 to 62 years, and no study in this review validated that benchmark for the neurological or older-adult populations it is being applied to. The authors themselves recommend tracking within-patient change under a consistent protocol rather than relying on normative comparison.
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