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Rehab Measures

10 Meter Walk Test

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Purpose

The 10MWT assesses walking speed in meters per second over a short duration.

Link to Instrument

Acronym 10MWT

Area of Assessment

Functional Mobility
Gait
Vestibular

Assessment Type

Performance Measure

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Brain Injury Recovery
  • Limb Loss & Impairment
  • Multiple Sclerosis
  • Parkinson's Disease & Movement Disorders
  • Spinal Cord Injury
  • Stroke Recovery

Key Descriptions

  • 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.
  • Two trials are administered at the patient’s comfortable walking speed, followed by 2 trials at his/her fast walking speed, per the below instructions. The 2 trials, for each speed, are averaged and the 2 gait speeds are documented in meters/second.
  • Considerations:
    1) Assistive devices may be used but must be documented from test to test.
    2) If a patient requires assistance, only the minimum amount of assistance required for a patient to complete the task should be provided. The level of assistance documented, however, should reflect the greatest amount of assistance provided during the test. For example, if a patient required minimum assistance for the majority of the test but required moderate assistance for stability on one occasion, the patient should be rated as requiring moderate assistance.
    3) The test can be performed at preferred walking speed or fastest speed possible (document preferred vs. fast).
    4) Test administrator should walk at least a half step behind the patient so as not to influence the patient's speed

Number of Items

1

Equipment Required

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

Time to Administer

5 minutes

Or less

Required Training

No Training

Age Ranges

Preschool Child

2 - 5

years

Child

6 - 12

years

Adolescent

13 - 17

years

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

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.

ICF Domain

Activity

Measurement Domain

Motor

Professional Association Recommendation

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 (Vestibular EDGE) 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: 

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
Vestibular EDGE 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
Vestibular EDGE 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
Vestibular EDGE 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)

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Multiple Sclerosis

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Criterion Validity (Predictive/Concurrent)

Multiple Sclerosis:

(Paltamaa et al, 2007; = 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 (= 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

Neuromuscular Conditions

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Test/Retest Reliability

Children with Neuromuscular Disease:

(Pirpiris, 2003; = 29; mean age = 11.5 (3.5) years (6-16), Children with Neuromuscular Disease)

  • Excellent test-retest reliability (ICC = 0.91)

Older Adults and Geriatric Care

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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

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

Responsiveness

Geriatrics:

(Perera et al, 2006, Geriatrics)

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

Parkinson's Disease

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Minimal Detectable Change (MDC)

Parkinson’s Disease:

(Steffen & Seney, 2008; = 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

Test/Retest Reliability

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)

Spinal Injuries

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Standard Error of Measurement (SEM)

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; = 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; = 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

Minimal Detectable Change (MDC)

SCI:

(Burns et al, 2011; = 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

Minimally Clinically Important Difference (MCID)

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

Normative Data

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; = 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 (= 0.663)

Test/Retest Reliability

SCI:

(Bowden & Behrman, 2007, SCI)

  • Excellent test-retest reliability (ICC = 0.97)

(Lam et al, 2008, SCI)

  • Excellent test-retest reliability (= 0.983)

Interrater/Intrarater Reliability

SCI:

(van Hedel et al, 2005, SCI)

  • Excellent intrarater reliability (= 0.983, < 0.001)
  • Excellent interrater reliability (= 0.974, < 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; = 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)

Construct Validity

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, = 47)
    • Poor correlation between the WISCI II and 10MWT when testing individuals with WISCI II scores 0 - 10 (r = -0.24, = 20)
    • Adequate but not significant correlation between WISCI II (0-8,10,11,14,17), dependent walkers (r = -0.35, = 15)
    • Adequate correlation between WISCI II (9,12,13,15,16,18-20) independent walkers (r = -0.48, = 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; = 63; mean age = 43.3 (13.8) years; mean time since injury = 6.32 (5.99) years, Chronic SCI)

Convergent

10 Meter Walk Speed

 

 

Validity

 

 

 

 

All

Tetraplegia

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, = 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 = 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

 

Content Validity

SCI:

(Jackson et al, 2008; = 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 (%)

 

 

 

 

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

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

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Standard Error of Measurement (SEM)

Stroke:

(Perera et al, 2006; = 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

Minimally Clinically Important Difference (MCID)

Stroke:

(Perera et al, 2006, Stroke)

  • Small meaningful change = 0.06 m/s

  • Substantial meaningful change = 0.14 m/s 

(Tilson, 2010; = 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

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

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

Stroke:

(Collen, 1990; = 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

Interrater/Intrarater Reliability

Stroke:

(Collen et al, 1990, Stroke)

  • Excellent intrarater reliability; ICC = 0.87 to 0.88

(Wolf et al, 1999; = 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)

Criterion Validity (Predictive/Concurrent)

Stroke:

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

Predictive Validity:

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

Construct Validity

Stroke:

(Lin et al, 2010; = 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)

Responsiveness

Stroke:

(Perera et al, 2006, Stroke)

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

Brain Injury

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Minimal Detectable Change (MDC)

TBI:

(Watson et al, 2002, = 10 patients with TBI who were walking independently with or without walking aids; = 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)

TBI:

(vanLoo and Moseley, 2004; = 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

Test/Retest Reliability

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 (= 0.97 - 0.99)

Interrater/Intrarater Reliability

TBI:

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

  • Excellent interrater reliability (ICC = 0.99)

Face Validity

TBI:

(Moseley et al, 2004, = 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

Joint Pain and Fractures

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Standard Error of Measurement (SEM)

Hip Fracture:

(Hollman et al, 2008, = 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

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

Normative Data

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

Test/Retest Reliability

Hip Fracture:

(Hollman et al, 2008, Hip Fracture)

  • Excellent test-retest reliability (ICC = 0.823 with 95% CI = 0.565 to 0.934)

Construct Validity

Hip Fracture:

(Latham et al, 2008, Hip Fracture)

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

Non-Specific Patient Population

back to Populations

Normative Data

Healthy adults: (Bohannon 1997; n=230 healthy volunteers)

 

Comfortable Gait Speed (cm/s)

 

 

 

Maximum Gait Speed (cm/s)

 

 

 

 

Actual

 

Height Normalized

 

Actual

 

Height Normalized

 

Sex/decade

X

s

X

s

X

s

X

s

Men

 

 

 

 

 

 

 

 

20s

139.3

15.3

0.7888

0.093

253.3

29.1

1.431

0.162

30s

145.8

9.4

0.828

0.052

245.6

31.5

1.396

0.177

40s

146.2

16.4

0.829

0.09

246.2

36.5

1.395

0.197

50s

139.3

22.9

0.794

0.119

206.9

44.8

1.182

0.259

60s

135.9

20.5

0.777

0.116

193.3

36.4

1.104

0.198

70s

133

19.6

0.762

0.105

207.9

36.3

1.192

0.201

 

 

 

 

 

 

 

 

 

Women

 

 

 

 

 

 

 

 

20s

140.7

17.5

0.856

0.098

246.7

25.3

1.502

0.142

30s

141.5

12.7

0.864

0.087

234.2

34.4

1.428

0.206

40s

139.1

15.8

0.856

0.098

212.3

27.5

1.304

0.16

50s

139.5

15.1

0.863

0.104

201

25.8

1.243

0.158

60s

129.6

21.3

0.808

0.131

177.4

25.4

1.107

0.157

70s

127.2

21.1

0.807

0.131

174.9

28.1

1.11

0.176

Healthy Adults (Bohannon RW & Andrews AW, 2011; n=23,111)

Strata  Gender (age in years)

Source artcles (n)

Subjects (n)

Gait Speed (cm/second)

Grand mean (95% CI) range

Homogeneity Q (P)

Men (20-29)

10

155

135.8 (127.0 to 144.7)

121.7 to 147.4

3.255 (0.953)

Men (30-39)

5

83

143.3 (131.6 to 155.0)

132.0 to 153.8

1.169 (0.883)

Men (40-49)

4

96

143.4 (135.3 to 151.4)

127.0 to 147.0

2.609 (0.625)

Men (50-59)

6

436

143.3 (137.9 to 148.8)

112.2 to 149.1

4.721 (0.580)

Men (60-69)

12

941

133.9 (126.6 to 141.2)

103.3 to 159.0

15.217 (0.294)

Men (70-79)

18

3671

126.2 (121.0 to 132.2)

95.7 to 141.8

12.848 (0.914)

Men (80-99)

10

1091

96.8 (83.4 to 110.1)

60.8 to 122.1

4.159 (0.940)

Women (20-29)

11

1091

134. 1 (123.9 to 144.3)

108.2 to 149.9

5.307 (0.870)

Women (30-39)

5

180

133.7 (119.3 to 148.2)

125.6 to 141.5

0.785 (0.940)

Women (40-49)

7

104

139.0 (133.9 to 141.1)

122.0 to 142.0

5.666 (0.579)

Women (50-59)

10

456

131.3 (122.2 to 140.5)

110.0 to 155.5

12.291 (0.266)

Women (60-69)

17

5013

124.1 (118.3 to 130.0)

97.0 to 145.0

11.515 (0.932)

Women (70-79)

29

8591

113.2 (107.2 to 119.2)

83.0 to 150.0

16.775 (0.998)

Women (80-99)

17

2152

94.3 (85.2 to 103.4)

55.7 to 117.0

11.428 (0.954)

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.

Bohannon, R.W.; Andrews, A. W. (2011). "Normal walking speed: a descriptive meta-analysis". Physiotherapy 97: 182-189.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.