Development, Validation and Test-retest Reliability of the Stroke Specific Gait Assessment Scale: A Cross-sectional Study

Introduction: Gait impairments are frequently observed after stroke and can significantly affect a patient's independence and overall Quality of Life (QoL). Despite their prevalence, standardised tools designed to assess gait in stroke survivors are lacking. The Stroke-Specific Gait Assessment Scale (SSGAS) was created to offer a detailed and comprehensive evaluation of gait function in stroke rehabilitation to address this gap. The present study outlines the development of the SSGAS and examines its content validity. Test-retest reliability was assessed using Interclass Correlation Coefficients (ICC) analysis. Aim: To develop and analyse the content validity and test-retest reliability of the SSGAS to assess gait in individuals who have suffered a stroke. Materials and Methods: The present cross-sectional content validation study was conducted at a tertiary hospital, Ambala, Haryana, India, from August 2024 to March 2025. The SSGAS was developed through extensive clinical research and consultation with a panel of experts to ensure it addressed the key gait parameters impacted by stroke. The scale consists of 24 items, each rated on a 0-4 ordinal scale. A group of eight validators, including physiotherapists and neurologists, reviewed the scale for relevance, clarity, and completeness. Content validity was measured using the Item-level Content Validity Index (I-CVI) and Scale-level Content Validity Index (S-CVI), both of which were assessed against established validity thresholds.Test-retest reliability was assessed using ICC. Results: The SSGAS demonstrated a high degree of validity, with an I-CVI of 0.98 and an S-CVI of 0.98 overall. These results indicate strong agreement among experts, affirming the scale’s comprehensiveness and clarity. The experts also expressed that the scale is both practical and valuable for planning rehabilitation and monitoring patient progress. Test-retest reliability was assessed with 51 patients and the ICC score was 0.99 which shows excellent reliability. Conclusion: The SSGAS has been validated as a comprehensive tool for assessing gait in stroke patients. Its excellent content validity underscores its potential as an essential resource in clinical practice and research, providing important information for developing personalised rehabilitation plans and tracking patient outcomes. Further research is recommended to examine the scale’s reliability across different populations of patients with stroke.