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Rehab Measures: 10 Meter Walk Test

Link to instrument

10 Meter Walk Test 

Title of Assessment

10 Meter Walk Test 

Acronym

10MWT

Instrument Reviewer(s)

Initially reviewed by the Rehabilitation Measures Team in 2010; Updated with references from the Alzheimer's Disease population by Jenna Poulter, SPT and Mackenzie Riebel, SPT in 2011; Updated with references from the Spinal Cord Injury population by Candy Tefertiller, PT, DPT, ATP, NCS and Jennifer H. Kahn, PT, DPT, NCS and the SCIEDGE task force of the Neurology section of the APTA in 2012; Updated with references from the Traumatic Brain Injury population by the TBIEDGE task force of the Neurology section of the APTA in 2012; Updated by Kathleen Chizewski, SPT and Jessica Wierdak, SPT in 11/2012; Updated with references from the Parkinson's Disease population by Jeffrey Hoder, PT, DPT, NCS and the PD EDGE tast force of the Neurology section of the APTA in 2013. Updated by  Karen Lambert PT, MPT, NCS and Linda B. Horn PT, DScPT, MHS, NCS of the VEDGE task force for the Neurology section of the APTA in 2013

Summary Date

1/22/2014 

Purpose

Assesses walking speed in meters per second over a short duration 

Description

The individual is instructed to walk a set distance (6 meters, 10 meters, etc).  Time is measured while the individual walks the set distance (often the individual is given space to accelerate to his/her preferred walking speed (this distance is not included when determining speed).  The distance covered is divided by the time it took the individual to walk that distance.

There are many variations of this test in the literature although the 10 Meter Walk test (10MWT) is the most common:

Collect three trials and calculate the average of the three trials

Considerations:

  • Assistive devices may be used but must be kept consistent and documented from test to test
  • This test is not appropriate if the individual requires physical assistance to ambulate
  •  The test can be performed at preferred walking speed or fastest speed possible (document preferred vs. fast)

 

Area of Assessment

Functional Mobility; Gait; Vestibular 

Body Part

Not Applicable 

ICF Domain

Activity 

Domain

Motor 

Assessment Type

Performance Measure 

Length of Test

05 Minutes or Less 

Time to Administer

< 5 minutes

Number of Items

1 (repeat 3 trials)  

Equipment Required

  • Stopwatch
  • Clear pathway 6, 8, 10, 12 meters in length depending on distance being tested

Training Required

No training

Type of training required

No Training 

Cost

Free 

Actual Cost

Free

Age Range

Preschool Child: 2-5 years; Child: 6-12 years; Adolescent: 13-17 years; Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode

Paper/Pencil 

Diagnosis

Acquired Brain Injury; Geriatrics; Hip Fracture; Lower Limb Amputation; Movement Disorders; Multiple Sclerosis; Parkinson’s Disease; Spinal Cord Injury; Stroke; Traumatic Brain Injury 

Populations Tested

  • Alzheimer's Disease
  • Brain Tumor
  • Children with Neuromuscular Diseases
  • Community Dwelling Older Adults
  • General Neurologic Movement Disorders
  • Hip Fracture
  • Lower Limb Amputation
  • Multiple Sclerosis (MS)
  • Parkinson’s Disease (PD)
  • Spinal Cord Injury (SCI)
  • Stroke
  • Traumatic Brain Injury (TBI)
  • Vestibular Disorders

Standard Error of Measurement (SEM)

Geriatrics:

(Parera et al, 2006; n = 100 older adults with mild to moderate mobility limitations in a strength training trial; mean age = 77.6 (7.6) years; two-armed randomized controlled clinical trial of a 3-month home-based strength training intervention; data from baseline and 3-month intervention assessments, Geriatrics)

  • SEM = 0.06 m/s

Hip Fracture:

(Hollman et al, 2008, n = 16, participants aged 77.9 (9.0) years, tested at a mean of 4.7 (2.0) days, range = 2 to 8 days, after surgical fixation of their hip fractures, after rest a second trial under the same parameters was conducted, Hip Fracture)

  • SEM = 0.03 m/s

SCI:

(Musselman, 2007; n = 19; mean age = 42; > 6 months post motor incomplete SCI, Chronic SCI)

  • SEM = 0.05 m/s

See Burns et al, 2011 in MDC data below, Chronic SCI

(van Hedel et al, 2005; n = 22; mean age = 45.5 (16.7) years; method not specified, "measures the time it takes a patient to walk 10m" SEM calculated by Lam et al, 2008, SCI)

  • SEM = 0.05 m/s

(Bowden & Behrman, 2007; n = 11; age range = 21 to 68 yrs; mean time post SCI = 24.0 (19.7 months), SCI)

  • SEM = 0.76 steps

(Flansbjer et al, 2005; n = 50; mean age = 58 (6.4) years; mean time since stroke onset = 15 (5) months; Swedish sample, Chronic SCI)

  • Comfortable gait speed: 0.07 m/s or 7.9% change
  • Fastest possible gait speed: 0.08 m/s or 5.7% change

Stroke:

(Perera et al, 2006; n = 100 subacute stroke survivors in an interventional trial; mean age = 69.8 (10.3) years; two-arm randomized trial of a 3-month program of therapeutic exercise in stroke survivors, Stroke)

  • SEM = 0.04 m/s

Minimal Detectable Change (MDC)

Hip Fracture: 
(Latham et al, 2008; aged > 65 years; within 17 days of surgical repair of hip fracture; sample included Norway, United Kingdom, Sweden, Israel, Germany, United States, Denmark, Spain; gait speed tested over 4 meters of walking after 12 weeks, Hip Fracture)
  • Gait speed MDC = 0.17 m/s

(Hollman et al, 2008, Hip Fracture)

  • MDC at 95% confidence level = 0.82 m/s

Parkinson’s Disease:

(Steffen & Seney, 2008; n = 37; mean age = 71; community dwelling adults with Parkinsonism; mean Hoehn & Yahr Stage of 2 (ranged 1 - 4), Parkinson's Disease)

  • Comfortable gait speed = 0.18 m/s
  • Fastest gait speed = 0.25 m/s

SCI:

(Burns et al, 2011; n = 63; mean age = 43.3 (13.8) years; mean time since injury = 6.32 (5.99) years; Chronic SCI)

SRD and SEM for 10 Meter Walking Speed when completing WISCI
SEM
SRD
SS WISCI (self selected)
Speed
0.091
0.254 m/s
Max WISCI (Maximum)
Speed
0.059
0.163 m/s

(Lam et al, 2008; SCI measures meta analysis, SCI)

  • A change of 0.13 m/s was found to detect significant clinical change for the 10MWT
TBI:
(Watson et al, 2002, n = 10 patients with TBI who were walking independently with or without walking aids; n = 28 healthy adults (no demographic information given; TBI)
  • Change in performance of > 0.05 seconds is greater than rater error (TBI)

Minimally Clinically Important Difference (MCID)

Geriatrics:

(Perera et al, 2006, Geriatrics)

  • Small meaningful change = 0.05 m/s
  • Substantial meaningful change = 0.13 m/s

SCI:

(Musselman et al, 2007, SCI)

  • MCID = 0.06 m/s

(Lam et al, 2008, SCI)

  • Smallest real difference = 0.13 m/s
  • Mean change between 1 and 3 months post injury, effect size = 0.92
  • Mean change between 3 and 6 months post injury, effect size = 0.47
Stroke:
(Perera et al, 2006, Stroke)
  • Small meaningful change = 0.06 m/s
  • Substantial meaningful change = 0.14 m/s 

(Tilson, 2010; n = 283; mean age = 63.5 (12.5) years; assessed at approximately day 20 and day 60 post stroke, 14m walk with middle 10 m timed with or without assistance, Acute Stroke)

  • MCID = 0.16 m/s

TBI:

(vanLoo and Moseley, 2004; n = 13; mean age = 32.5 (11.3) years; average time post injury 11.9 (15.7) months; mean initial GCS 5.8 (2.9); mean PTA 43.8 (39.1) days, walked 14 meters with middle 10 timed, TBI)

  • Change is reflected by 0.15 and 0.25 m/s increase in comfortable and fast-paced walking speed respectively

(Watson et al, 2002, TBI)

  • Change in performance of > 0.05 is attributed to "real variation in severe TBI subjects

Cut-Off Scores

Stroke:

Ambulation ability has been correlated with gait speed (Perry et al, 1995); changes in gait speed that result in a transition to a higher category of ambulation classification resulted in better function and quality of life (Schmid et al, 2007); ambulation ability that is predicted by gait speed is a reliable method of classifying patients (Bowden et al, 2008)

  • < 0.4 m/s were more likely to be household ambulators
  • 0.4 - 0.8 m/s limited community ambulators
  • > 0.8 m/s were community ambulators

Normative Data

Healthy Adults:
(Bohannon, 1997; n = 230 healthy volunteers; age 20-79, measured over 7.62 m with acceleration and deceleration period)
 

Male

Female
Age
Comfortable
Fast
Comfortable
Fast
20's
1.39
2.53
1.41
2.47
30's
1.46
2.45
1.42
2.34
40's
1.46
2.46
1.39
2.12
50's
1.39
2.07
1.40
2.01
60's
1.36
1.93
1.30
1.77
70's
1.33
2.08
1.27
1.74
*Comfortable/ fast gait speed in meters/ second for male and females by decade
 
(Watson, 2002; n = 28, median age 19 years, UK sample, Non-impaired Population)
  • mean velocity = 1.49 m/s

Hip Fracture:

(Hollman et al, 2008, Hip Fracture)

  • Trial 1: Mean (± SD) 10MWT (m/s) score; for Hip Fracture 0.15 ± 0.05 m/s, (range = 0.08 to 0.24 m/s)
  • Trial 2: Mean (± SD) 10MWT (m/s) score; for Hip Fracture 0.16 ± 0.07 m/s, (range = 0.07 to 0.36 m/s)
    • The Bland-Altman plot indicates that no systemic bias between the first and second trials occurred
    • Mean difference in gait velocity between trial 1 and trial 2 was 0.013 m/s, with limits of agreement between -0.057 and 0.083 m/s

SCI:

(Lemay & Nadeau, 2010; n = 32; all participants were AIS D; mean age = 47.9 (12.8); mean time post lesion 77.2 (44.3) days, middle 10 m of 15 m timed, Acute SCI)

  • Mean (SD) 10MWT (m/s) score; 0.81 (0.34) m/s, range = 0.08 to 1.43
    • Mean (SD) 10MWT for Paraplegia; 0.73 (0.32) m/s, range = 0.08 to 1.35
    • Mean (SD) 10MWT for Tetraplegia; 0.87 (0.34) m/s, range = 0.34 to 1.43

(Olmos et al, 2008; n = 18; all participants were AIS D; time post injury = 6 months; tested three times each with a 60 minute interval between test run, method not specified, "measures the time it takes a patient to walk 10 m", Chronic SCI)

Ten-Meter Walking Test (m/s)
10MWT – gym
10MWT – community
Mean
1.3706
1.3567
Median
1.3400

1.3150

SD

0.39251

0.39079
Min
0.52
0.51
Max

2.12

1.91

**No statistical difference was observed in gait speed when completing 10MWT in therapy gymnasium vs. community environment (p = 0.663)

Stroke:

(Severinsen et al, 2011, n = 48, participants aged 68 (9) years, with reduced muscle strength and walking capacity due to an ischemic stroke 18 (6) prior to recruitment, performed 3 times, using the mean value in further analyses, Stroke)

  • Mean (± SD) 10MWT (m/s) score; for Stroke 0.84 ± 0.3 m/s
  • Normalized Test Values % (95% CI); 59 (52–66)%

Test-retest Reliability

Children with Neuromuscular Disease:
(Pirpiris, 2003; n = 29; mean age = 11.5 (3.5) years (6-16), Children with Neuromuscular Disease)
  • Excellent test-retest reliability (ICC = 0.91)

Healthy Adults:

(Watson et al, 2002, Healthy Adults)

  • Excellent test-retest reliability for comfortable gait speed (r = 0.75 - 0.90)

(Bohannon, 1997, Healthy Adults)

  • Excellent test-retest reliability for comfortable and fastest gait speeds (ICC = 0.93 - 0.91)

Hip Fracture:

(Hollman et al, 2008, Hip Fracture)

  • Excellent test-retest reliability (ICC = 0.823 with 95% CI = 0.565 to 0.934)
Parkinson’s Disease or Parkinsonism:
(Steffen & Seney, 2008, Parkinson's or Parkinsonism)
  • Excellent test-retest reliability for comfortable gait speed (ICC = 0.96)
  • Excellent test-retest reliability for maximum gait speed (ICC = 0.97)

SCI:

(Bowden & Behrman, 2007, SCI)

  • Excellent test-retest reliability (ICC = 0.97)

(Lam et al, 2008, SCI)

  • Excellent test-retest reliability (r = 0.983)
Stroke:
(Collen, 1990; n = 25; mean age = 72 years; stroke onset = 2 to 6 years, Chronic Stroke)
Test-retest assessed three times within a single session:
  • Excellent test-retest reliability (ICC = 0.95 to 0.99)

(Flansbjer et al, 2005, Chronic Stroke)

  • Excellent reliability for comfortable (ICC = 0.94) and fast (ICC = 0.97) gait speeds

TBI:

(vanLoo et al, 2004, TBI)

  • Excellent between day reliability at comfortable (ICC = 0.95) and fast speeds (ICC = 0.96)

(Watson et al, 2002, TBI)

  • Excellent test-retest reliability (r = 0.97 - 0.99)

Interrater/Intrarater Reliability

Healthy Adults:

(Wolf et al, 1999; n = 28 healthy adults; mean age = 56.43 (13.82) years; Healthy Adults)

  • Excellent interrater reliability; (ICC = 0.980)

SCI:

(van Hedel et al, 2005, SCI)

  • Excellent intrarater reliability (r = 0.983, p < 0.001)
  • Excellent interrater reliability (r = 0.974, p < 0.001)
  • Bland-Altman plots indicate reliability Excellent when completed in under 40 seconds, but reliability decreases with marginal walkers requiring > 40 seconds to complete

(Scivoletto et al, 2011; n = 37; median age = 58.5 (range 19 - 77) years; median time from onset = 24 (range 6 - 109) months; AIS D = 35, C = 2; Median WISCI = 16, utilized 2 methods, measured 10 m with a static start and measured middle 10 m of 14 m walkway to include acceleration and deceleration, Chronic SCI)

For both methods:

  • Excellent interrater reliability (ICC > 0.95)
  • Excellent intrarater reliability (ICC > 0.98)

Stroke:

(Collen et al, 1990, Stroke)

  • Excellent intrarater reliability; ICC = 0.87 to 0.88

(Wolf et al, 1999; n = 28 with history of stroke; mean age = 56.04 (12.80) years; mean time since lesion = 13.59 (12.30) months, Chronic Stroke)

 

  • Excellent interrater reliability; (ICC = 0.998)

TBI:

(Tyson & Connell, 2009; review of seventeen measures; n = 12 mobile TBI patients, TBI)

  • Excellent interrater reliability (ICC = 0.99)

Internal Consistency

Not Established

Criterion Validity (Predictive/Concurrent)

Multiple Sclerosis:

(Paltamaa et al, 2007; n = 120; mean age = 45.0 (10.8) years; mean duration since symptom onset 12.3 (8.8) years, MS)

 

Predictive Validity:

  • Excellent correlation with dependence in self-care (r = 0.60 - 0.87) at comfortable speed
    • Independent vs. perceived difficulties in self-care:
      • OR = 0.72 (0.60 - 0.87) comfortable speed
      • OR = 0.52 (0.37 - 0.73) fastest possible speed
  • Adequate to Excellent correlation with dependence in mobility (r = 0.34 - 0.74) at comfortable speed
    • Independent vs. perceived difficulties in mobility
      • OR = 0.50 (0.34 - 0.74) comfortable speed
      • OR = 0.38 (0.21 - 0.67) fastest possible speed
  • Adequate to excellent correlation with dependence in domestic life (r = 0.34 - 0.81) at comfortable speed
    • Independent vs. perceived difficulties in domestic life
      • OR = 0.53 (0.34 - 0.81) comfortable speed
      • OR = 0.63 (0.39 - 1.02) fastest possible speed

Stroke:

(Tyson & Connell, 2009; n = 40, review article of 17 measures, Stroke)

Predictive Validity:

  • Excellent correlation with dependence in instrumental activities of daily living (r = 0.76)
  • Excellent correlation with Barthel Index (r = 0.78)

Construct Validity (Convergent/Discriminant)

Healthy Adults:

(Wolf et al, 1999, Healthy Adults)

  • Poor correlation with BBT (r = 0.052)
  • Adequate correlation with FRT (r = 0.307)

Hip Fracture:

(Latham et al, 2008, Hip Fracture)

  • Excellent correlation with 6MWT (correlation coefficient = 0.82)
  • Adequate correlation with LE strength (r = 0.51)
  • Adequate correlation with LE power (r = 0.58)
  • Poor correlation with hip pain (r = -0.23)
  • Poor correlation with bodily pain (r = 0.30)
  • Poor correlation with vitality (r = 0.26)
  • Adequate correlation with physical role (r = 0.54)
  • Adequate correlation with social role (r = 0.42)

SCI:

(vanHedel et al, 2005; quoted from Lam et al,2008 SCI measures meta analysis, SCI)

 

Convergent Validity:

  • Excellent correlation between the TUG and 10MWT (r  = 0.89, n = 70)
  • Excellent correlation between 10MWT and 6MWT (ρ = -0.95, n = 62)
  • Subgroup comparisons of WISCI II and 10MWT
    • Excellent correlation between WISCI II and 10MWT when testing individuals with WISCI II scores 11 - 20 (p = -0.68, n = 47)
    • Poor correlation between the WISCI II and 10MWT when testing individuals with WISCI II scores 0 - 10 (r = -0.24, n = 20)
    • Adequate but not significant correlation between WISCI II (0-8,10,11,14,17), dependent walkers (r = -0.35, n = 15)
    • Adequate correlation between WISCI II (9,12,13,15,16,18-20) independent walkers (r = -0.48, n = 43)
  • Overall, improved validity in individuals who are less impaired, higher walking ability, and do not require assistance

 (Lemay & Nadeau, 2010, Acute SCI)

Convergent Validity Evidence:
Measure
10MWT
Rating
BBS
0.792**
Excellent
2MWT
0.932 a**
Excellent
WISC II
0.795**
Excellent
SCI-FAI parameter
0.777**
Excellent
SCI-FAI assistive devices
0.788**
Excellent
SCI-FAI mobility
0.756**
Excellent
a = Pearson’s product moment correlation; other coefficients are Spearman’s r
**Significant at p < 0.01

Abbreviations: BBS, Berg Balance Scale; 2MWT, 2-min walk test; SCI-FAI, Spinal Cord Injury Functional Ambulation Inventory; TUG, Timed up and go; WISCI II, Walking Index for Spinal Cord Injury (version II)

 

(Burns et al, 2011; n = 63; mean age = 43.3 (13.8) years; mean time since injury = 6.32 (5.99) years, Chronic SCI)

 

Convergent
Validity
10 Meter Walk Speed
All
Tetraplegic
Paraplegic
SS WISCI
(Self Selected)
r = 0.584
Adequate
r = 0.724 Excellent
r = 0.349
Adequate
Max WISCI
(Maximum)
r = 0.693
Excellent
r = 0.780
Excellent
r = 0.521
Adequate

 

(van Hedel et al 2006, n = 22, incomplete SCI who could ambulate within the 1st month post SCI, measured at 1 mo, 3 mo, 6 mo, and 12 mo post, middle 10 m of 14 m walk used, SCI)

 

LEMS
WISCI II
6MWT
Within 1 Month
10 MWT
Adequate r =
0.45**
Excellent r = 0.79*
Excellent r = 0.91*
After 3 Months
10 MWT
Adequate r = -0.30
Poor r = -0.21
Excellent r = -0.91*
After 6 months
10 MWT
Adequate r = -0.40
Adequate r = -0.37
Excellent r = -0.87*
After 12 months
10 MWT
Adequate r = -0.39
Adequate r = -0.37
Excellent r = -0.86*
  • p < 0.001
  • **p = 0.04
  • Spearman's correlations

 

(van Hedel et al, 2007; Longitudinal study looking at 6min and 10MWT at 1, 3, and 6 mo post injury, incomplete SCI who were able to ambulate 10m within 3 months post SCI n = 51, 22 tetraplegic, 29 paraplegic; cross sectional study  n = 18 incomplete SCI, acute and chronic range 2 weeks to 8 years AIS C or D, utilized middle 10 m of 14 m walk; Acute; Subacute, SCI)

  • Walking speed differed at each time period (1, 3, 6 mo post) but did not differ between the tests
  • Regression analysis performed to look at relationship between the tests at preferred and maximum walking speed
    • Preferred walking speed R2 = 0.87
    • Maximum walking speed R2 = 0.86

(van Hedel et al, 2008)

  • Excellent correlation of TUG and 10M; however, relationship changes over time.

Time Since Injury
R2
2 Weeks
0.96 Excellent
1 Month
0.57 Adequate
3 Months
0.75 Excellent
6 Months
0.76 Excellent
12 Months
0.78 Excellent

 

Stroke:

(Lin et al, 2010; n = 45; time post stroke = >1 year, Stroke)

Convergent validity for the 10MWT
Time point of assessment

DGI

DGI-4

FGA

First week of therapy
-0.68 Excellent
-0.61 Excellent
-0.66 Excellent
2 months after therapy
-0.87 Excellent
-0.77 Excellent
-0.85 Excellent
5 months after therapy
-0.83 Excellent
-0.74 Excellent
-0.81 Excellent
All p values < 0.001

(Wolf et al, 1999, Stroke)

  • Excellent correlation with BBS (r = 0.627)
  • Adequate correlation with FRT (r = 0.349)

(Flansbjer et al, 2005, Chronic Stroke)

  • Excellent correlation between comfortable gait speed and TUG (ICC = -0.84), FGS (ICC = 0.92), Stair climbing ascend (SCas) (ICC = -0.81), Stair climbing descend (SCde) (ICC = -0.82), 6MWT (ICC = 0.89)
  • Excellent correlation between fast gait speed and TUG (ICC = -0.91), CGS (ICC = 0.88), SCas (ICC = -0.84), SCde (ICC = -0.87) and 6MWT (ICC = 0.95)

Content Validity

SCI:
(Jackson et al, 2008; n = 54 expert raters asked to assess each measure in three categories: valid or useful, useful but requires validation or changes/improvements, not useful or valid for research in SCI, SCI)
 

Expert Evaluations:

Measure
Valid or Useful
Useful but requires validation
Not useful or valid for RESEARCH
Total Votes
10 Meter Walk Test

32 (60%)

20 (38%)

1 (2%)

53

6 Minute Walk Test
19 (37%)
30 (58%)
3 (6%)
52
FIM-L
3 (6%)
18 (36%)
29 (58%)
50
Votes (%)

Face Validity

TBI:

(Moseley et al, 2004, n = 10, mean age 31.9 (14.2) years, mean days post injury = 56.4 (25.5); mean duration of PTA = 26.6 (8.7) days, 14 m walk with central 10 m timed, TBI)

  • Poor correlation between 10 meter walk test in clinic compared to natural environments including: parking lot in shopping center (ICC = -0.024), Inside a shopping center (ICC = -0.14), corridor in a brain injury unit (ICC = 0.21)
  • Walking speed is faster when measured under clinical conditions in individuals with TBI

Floor/Ceiling Effects

SCI:
(Lemay & Nadeau, 2010, SCI)
  • 10MWT did not demonstrate a ceiling effect and as such allows for further differentiation among subjects with high scores on the BBS (37.5% ceiling effect found in this study)

*Ceiling effect defined as > 20% of subjects reach the maximum score

Responsiveness

Geriatrics:

(Perera et al, 2006, Geriatrics)

  • Small meaningful change = 0.05 m/s
  • Substantial meaningful change = 0.10 m/s

SCI:

(Lam et al, 2008, SCI)

  • Smallest real difference = 0.13 m/s
  • Mean change between 1 and 3 months post injury, effect size = 0.92
  • Mean change between 3 and 6 months post injury, effect size = 0.47

(van Hedel et al, 2006, SCI)

  • 10MWT responsive between 1 - 3 months at P < 0.001
  • 10MWT responsive between 3 - 6 months at P = 0.005
    • Effect size greater 1 - 3 months post injury vs. 3 - 6 months post injury;
  • 10MWT NOT responsive > 6 months at P = 0.91
    • Small sample size who reached normal walking speeds (1.39 m/s) at 6 months
    • Statistically significant correlation between 10MWT and 6MWT remained at 12 months post injury (< 0.001)
  • The 10MWT was found to be more responsive in detecting locomotor improvement than the WISCI II in individuals who achieved greater overall walking ability (WISCI II scores ≥ 20) at 6 months post injury (AIS D)

Stroke:

(Perera et al, 2006, Stroke)

  • Small meaningful change = 0.05 m/s
  • Substantial meaningful change = 0.10 m/s

Professional Association Recommendations

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post)

(Vestibular < 6 weeks post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

SCI EDGE

HR

HR

HR

StrokEDGE

HR

HR

HR

VEDGE

LS

LS

LS

 

Recommendations Based on Parkinson Disease Hoehn and Yahr stage:

 

I

II

III

IV

V

PD EDGE

HR

HR

HR

R

NR

 

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

MS EDGE

 

 

 

 

 

StrokEDGE

HR

HR

HR

HR

HR

TBI EDGE

LS

R

LS

R

LS

 

Recommendations based on SCI AIS Classification:

 

AIS A/B

AIS C/D

SCI EDGE

LS

HR

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

R

LS

LS

NR

 

Recommendations based on EDSS Classification:

 

EDSS 0.0 – 3.5

EDSS 4.0 – 5.5

EDSS 6.0 – 7.5

EDSS 8.0 – 9.5

 

Recommendations based on vestibular diagnosis

 

Peripheral

Central

Benign Paroxysmal Positional Vertigo (BPPV)

Other

VEDGE

LS

LS

LS

LS

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

MS EDGE

 

 

 

 

PD EDGE

Yes

Yes

Yes

Not reported

SCI EDGE

Yes

Yes

Yes

Not reported

StrokEDGE

Yes

Yes

Yes

Not reported

TBI EDGE

Yes

Yes

Yes

Not reported

VEDGE

Yes

Yes

Yes

Yes

Considerations

  • Many studies utilized different methods of conducting the 10MWT
  • No significant difference noted when comparing static and dynamic starts in chronic incomplete SCI (Scivoletto et al, 2011)
  • A combination of the 10MWT and WISCI II were recommended by an expert committee assembled by the National Institute on Disability and Rehabilitation Research (NIDRR) to provide the most valid measure of improvement in ambulation and gait in SCI (Jackson et al, 2008)
  • There is value in collecting both self selected and maximum walking speeds (van Hedel, 2007)

Bibliography

Bohannon, R. W. (1997). "Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants." Age Ageing 26(1): 15-19. Find it on PubMed

Bowden, M., Balasubramanian, C., et al. (2008). "Validation of a speed-based classification system using quantitative measures of walking performance poststroke." Neurorehabilitation and neural repair 22(6): 672. Find it on PubMed

Bowden, M. G. and Behrman, A. L. (2007). "Step Activity Monitor: accuracy and test-retest reliability in persons with incomplete spinal cord injury." J Rehabil Res Dev 44(3): 355-362. Find it on PubMed

Burns, A. S., Delparte, J. J., et al. (2011). "The reproducibility and convergent validity of the walking index for spinal cord injury (WISCI) in chronic spinal cord injury." Neurorehabil Neural Repair 25(2): 149-157. Find it on PubMed

Collen, F., Wade, D., et al. (1990). "Mobility after stroke: reliability of measures of impairment and disability." Disability & Rehabilitation 12(1): 6-9. Find it on PubMed

Flansbjer, U. B., Holmback, A. M., et al. (2005). "Reliability of gait performance tests in men and women with hemiparesis after stroke." J Rehabil Med 37(2): 75-82. Find it on PubMed

Fritz, S. and Lusardi, M. (2009). "White paper:“walking speed: the sixth vital sign”." Journal of geriatric physical therapy 32(2): 2-5.

Hollman, J. H., Beckman, B. A., et al. (2008). "Minimum detectable change in gait velocity during acute rehabilitation following hip fracture." J Geriatr Phys Ther 31(2): 53-56. Find it on PubMed

Jackson, A. B., Carnel, C. T., et al. (2008). "Outcome measures for gait and ambulation in the spinal cord injury population." Journal of Spinal Cord Medicine 31(5): 487-499. Find it on PubMed

Jackson, A. B., Carnel, C. T., et al. (2008). "Outcome measures for gait and ambulation in the spinal cord injury population." J Spinal Cord Med 31(5): 487-499. Find it on PubMed

Lam, T., Noonan, V., et al. (2007). "A systematic review of functional ambulation outcome measures in spinal cord injury." Spinal Cord 46(4): 246-254. Find it on PubMed

Latham, N., Mehta, V., et al. (2008). "Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients?" Archives of physical medicine and rehabilitation 89(11): 2146-2155. Find it on PubMed

Lemay, J. F. and Nadeau, S. (2010). "Standing balance assessment in ASIA D paraplegic and tetraplegic participants: concurrent validity of the Berg Balance Scale." Spinal Cord 48(3): 245-250. Find it on PubMed

Lin, J. H., Hsu, M. J., et al. (2010). "Psychometric comparisons of 3 functional ambulation measures for patients with stroke." Stroke 41(9): 2021-2025. Find it on PubMed

Moseley, A. M., Lanzarone, S., et al. (2004). "Ecological validity of walking speed assessment after traumatic brain injury: a pilot study." J Head Trauma Rehabil 19(4): 341-348. Find it on PubMed

Musselman, K. (2007). "Clinical significance testing in rehabilitation research: what, why, and how?" Physical Therapy Reviews 12(4): 287-296.

Musselman, K. E., Fouad, K., et al. (2009). "Training of walking skills overground and on the treadmill: case series on individuals with incomplete spinal cord injury." Phys Ther 89(6): 601-611. Find it on PubMed

Olmos, L. E., Freixes, O., et al. (2008). "Comparison of gait performance on different environmental settings for patients with chronic spinal cord injury." Spinal Cord 46(5): 331-334. Find it on PubMed

Paltamaa, J., Sarasoja, T., et al. (2007). "Measures of physical functioning predict self-reported performance in self-care, mobility, and domestic life in ambulatory persons with multiple sclerosis." Archives of physical medicine and rehabilitation 88(12): 1649-1657. Find it on PubMed

Perera, S., Mody, S., et al. (2006). "Meaningful change and responsiveness in common physical performance measures in older adults." Journal of the American Geriatrics Society 54(5): 743-749. Find it on PubMed

Perry, J., Garrett, M., et al. (1995). "Classification of walking handicap in the stroke population." Stroke 26(6): 982. Find it on PubMed

Pirpiris, M., Wilkinson, A., et al. (2003). "Walking speed in children and young adults with neuromuscular disease: comparison between two assessment methods." Journal of Pediatric Orthopaedics 23(3): 302. Find it on PubMed

Reuben, D. B., Magasi, S., et al. (2013). "Motor assessment using the NIH Toolbox." Neurology 80(11 Supplement 3): S65-S75.

Schenkman, M., Cutson, T. M., et al. (1997). "Reliability of impairment and physical performance measures for persons with Parkinson's disease." Phys Ther 77(1): 19-27. Find it on PubMed

Schmid, A., Duncan, P., et al. (2007). "Improvements in speed-based gait classifications are meaningful." Stroke 38(7): 2096. Find it on PubMed

Scivoletto, G., Tamburella, F., et al. (2011). "Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients." Spinal Cord 49(6): 736-740. Find it on PubMed

Severinsen, K., Jakobsen, J. K., et al. (2011). "Normalized muscle strength, aerobic capacity, and walking performance in chronic stroke: a population-based study on the potential for endurance and resistance training." Arch Phys Med Rehabil 92(10): 1663-1668. Find it on PubMed

Steffen, T. and Seney, M. (2008). "Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism." Physical Therapy 88(6): 733-746. Find it on PubMed

Tilson, J. K., Sullivan, K. J., et al. (2010). "Meaningful gait speed improvement during the first 60 days poststroke: minimal clinically important difference." Phys Ther 90(2): 196-208. Find it on PubMed

Tyson, S. and Connell, L. (2009). "The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: a systematic review." Clin Rehabil 23(11): 1018-1033. Find it on PubMed

van Hedel, H., Wirz, M., et al. (2006). "Improving walking assessment in subjects with an incomplete spinal cord injury: responsiveness." Spinal Cord 44(6): 352-356.

van Hedel, H. J., Dietz, V., et al. (2007). "Assessment of walking speed and distance in subjects with an incomplete spinal cord injury." Neurorehabil Neural Repair 21(4): 295-301. Find it on PubMed

van Hedel, H. J., Wirz, M., et al. (2005). "Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests." Archives of Physical Medicine and Rehabilitation 86(2): 190-196. Find it on PubMed

van Hedel, H. J., Wirz, M., et al. (2008). "Standardized assessment of walking capacity after spinal cord injury: the European network approach." Neurol Res 30(1): 61-73. Find it on PubMed

van Loo, M. A., Moseley, A. M., et al. (2004). "Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study." Brain Inj 18(10): 1041-1048. Find it on PubMed

Watson, M. J. (2002). "Refining the ten-metre walking test for use with neurologically impaired people." Physiotherapy 88(7): 386-397.

Wolf, S. L., Catlin, P. A., et al. (1999). "Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile." Phys Ther 79(12): 1122-1133. Find it on PubMed

Year published

1987 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 10/30/2010 11:36 AM  by Dawood Ali 
Last modified at 8/28/2014 2:28 PM  by Jason Raad