Koval’s grade is a tool used to evaluate walking dependency. It is classified into seven grades: independent community ambulators (grade 1), community ambulators with a cane (grade 2), community ambulators with walker/crutches (grade 3), independent household ambulators (grade 4), household ambulators with a cane (grade 5), household ambulators with walker/crutches (grade 6), and nonfunctional ambulators (grade 7). A community ambulator refers to a person who can walk indoors or outdoors either independently or with assistive devices. A household ambulator is restricted to walking indoors either independently or with assistive devices. A nonfunctional ambulator refers to a person who is bed-bound or needs help moving from a bed to a chair [21].
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