## 4 Discussion  
The aim of this study was to cross-culturally adapt the FGA scale into the Greek language and to test its psychometric characteristics. Overall, the translation process was considered easy to be performed and the Greek version of the FGA scale was characterized as easy to administer and comprehensible in its content and commands to the patients. No items needed to be changed from the original scale during the translation process, apart from the measurements in inches and feet that were replaced with the equivalent values in centimeters which are used in Greece. The psychometric evaluation revealed a measurement tool that is reliable and valid in assessing the functional gait and able to predict those healthy older individuals who are at risk for falls. The above results provide evidence for the applicability of the adapted FGA\({}_{\text{GR}}\) instrument in a clinical setting. Indeed, the easy clinical administration of the scale as well as the excellent reliability of the Greek version in repeated measures and within raters support its utility for assessing functional gait in older adults, with the prerequisite that clinicians should be trained before the use of the scale. In the present study, measurements were made by physical therapists with experience in patient assessment and after being trained by the person in charge of the research, who is specialized in the use of functional neurological evaluation instruments. The Brazilian cross-cultural adaptation of the scale as well as the research by [PERSON] et al. are in agreement with the present study, presenting almost perfect inter-rater and test-retest reliability (ICC > 0.90) when the scale was undertaken by community-living older adults [15,25]. The German translation, made in stroke patients, also found excellent reliability (ICC = 0.94) [23]. Although not in healthy elderly, other studies in neurological patients such as patients with Parkinson's disease [54] and people with stroke [55] found similarly high test-retest and inter-rater reliability. Research on patients with vestibular disorders found the lowest inter-examiner reliability of the aforementioned studies (ICC = 0.84) [14]. Despite the almost perfect inter-rater reliability of total scores, the FGA\({}_{\text{GR}}\) presented some variability in single items reliability, with items 6 (\"over obstacles\") and 7 (\"tandem walking\") presenting the lowest inter-rater reliability. Similar low single item values for inter-rater reliability were present in the original scale, as well [14]. The difficulty in performing these tasks by the patients may lead the raters to be somehow strict in assigning the normal score to a patient unless he is almost perfect in his performance. This may have led to the variability in scores between raters. The above tasks as well as item 5 (\"pivot turn\") yielded a similar variability in single item test-retest reliability, indicating again the difficulty in performing the task, and thus the different ways of coping with these items between the repeated measures. The original scale also presented such test \begin{table}
\begin{tabular}{c c} \hline \hline
**Variable** & **FGA\({}_{\text{GR}}\)** \\ \hline AUC & 0.921 (0.80–1.00) \\ Cutoff point (/30) & 25 \\ Sensitivity (95\% CI) & 0.84 (0.64–0.96) \\ Specificity (95\% CI) & 0.50 (0.16–0.84) \\ True Positive & 16 \\ False Positive & 3 \\ True Negative & 0 \\ Positive Likelihood Ratio (LR+) & 0 \\ Negative Likelihood Ratio (LR\(-\)) & 0.16 \\ Positive Predictive Value (\%) & 100 \\ Negative Predictive Value (\%) & 86 \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Ability of the FGA\({}_{\text{GR}}\) to identify participants with high risk for falls. retest variability in difficult single items [14]. The items that also showed a weak and not significant correlation with the total score are those items that have been previously reported to deteriorate with age such as walking on an even surface (item 1), over obstacles (item 6), and on stairs (item 10). [PERSON] et al.