Grade 0: Non-functional Patient is unable to walk and requires a wheelchair or assistance from 2 people to walk. Level I: Requires a lot of continuous assistance Requires the use of a double crutch or requires continuous assistance from 1 person to walk and maintain balance Grade II: Requires little assistance Can walk but balance is poor and unsafe, requires 1 person to be present to give continuous or intermittent body contact assistance or requires the use of a knee-ankle-foot orthosis (KAFO), ankle-foot orthosis (AFO), a single crutch, cane, etc. to maintain balance and ensure safety. Level III: Requires supervision or verbal guidance Able to walk, but not normal or safe enough, requires 1 person for supervision or verbal guidance, but no body contact Level IV: Independent on level ground Able to walk independently on level ground, but still has difficulty walking up and down slopes, on uneven ground, or up and down stairs, requiring the assistance or supervision of another person Grade V: Fully independent Able to walk independently anywhere. Holden’s Grading of Walking Function (simplified) Grade 0 – patient cannot walk or requires assistance from more than 2 people; Grade 1 – patient requires 1 person to help transfer weight consistently and forcefully; Grade 2 – patient requires 1 person to help balance or coordinate consistently or intermittently; Grade 3 – patient requires 1 person for verbal management or companionship without physical contact; Grade 4 – patient can walk independently on a flat surface, but requires assistance when walking up and down steps, on inclined or uneven surfaces; Level 5 – the patient can go anywhere independently.