Enhanced Gait Variability Index in Neurological and Geriatric Rehabilitation: A Scoping Review.

BackgroundGait variability is a sensitive marker of neuromotor function and a clinically relevant indicator of fall risk and mobility impairment in neurological and geriatric populations. The Enhanced Gait Variability Index (eGVI) has emerged as a promising composite measure that captures multidimensional gait irregularity in a single interpretable score, offering a practical advantage over single-parameter approaches. Despite growing clinical interest, the evidence base supporting its standardized implementation has not been mapped.ObjectivesTo characterize populations and clinical contexts where the eGVI has been applied, map assessment protocol heterogeneity, and identify methodological gaps limiting precision medicine-aligned implementation in neurological and geriatric rehabilitation.MethodsA scoping review following PRISMA-ScR guidelines was conducted using PubMed, CINAHL, Scopus, Emcare, and Web of Science. Peer-reviewed studies reporting eGVI outcomes were included. Data were extracted on participant characteristics, gait assessment protocols, and outcomes, with attention to factors influencing clinical interpretation.ResultsEighteen studies involving 1,915 participants were included, predominantly examining Parkinson's disease (39%) and older adult populations (22%). The eGVI demonstrated preliminary sensitivity to neuromotor impairment, age-related gait changes, and increased task complexity during dual-task walking; findings were most consistent in Parkinson's disease, based on limited number of studies (n = 7). Substantial heterogeneity in walkway systems, walking conditions, assistive device use, and reference populations limited comparability.ConclusionWhile the eGVI shows promise as a clinical outcome measure, protocol variability and reliance on a single unvalidated normative reference limit its clinical use. Population-specific protocols and normative data consistent with a precision medicine approach, are essential for reliable adoption.