Introduction. Research and clinical settings use the 10-meter walk test (10MWT) to measure locomotor capacity with considerable methodological diversity. Comparison between healthy and disabled children is frequent; however, the reproducibility of 10MWT using different methods is unknown. Objectives. This study analysed intrasubject, test-retest reliability, and agreement of four methods of 10MWT, exploring the influence of pace, acceleration-deceleration phases, and anthropometric measurements when calculating mean velocity. Methods. This cross-sectional study evaluated 120 typical children, both sexes, aged 6, 8, 10, and 12 (n=30 for each age). The mean times and velocities of the path (10 m) and middle path (6 m) obtained at a self-selected and fast pace were analysed. Initial assessment and another after seven days recorded three measurements per method (sV6 = self-selected pace and 6 m; sV10 = self-selected pace and 10 m; fV6 = fast pace and 6 m; fV10 = fast pace and 10 m). Interclass correlation coefficient (ICC), multiple regression, and Snedecor-F test (5% significance level) were used. Results. The fV10 method had high intrasubject reliability for all tested ages (0.70<ICC>0.89); sV10 exhibited high intrasubject reliability for ages 6, 8, and 12 (0.70<ICC>0.89) and moderate for age 10 (0.50<ICC<0.69).Test-retest reliability at sV6 and fV6 did not reach high ICC in any tested ages. The test-retest reliability at sV10 and fV10 was moderate for ages 6, 8, and 12 (0.50<ICC>0.69) and poor for age 10 (0.25<ICC>0.49). There was no agreement between methods: sV6 versus sV10 (mean difference=0.91 m/s; SEM=0.036); fV6 versus fV10 (mean difference=1.70; SEM=0.046). The fV6 method versus fV10 overestimated the velocity (bias=1.70 m/s). Conclusions. For typical children, the method that ensured the highest intrasubject reliability used fast pace and 10 m. Moreover, test-retest reliability increased when adopting 10 m at both self-selected and fast pace. The methods were not equivalent but were related, and those that did not compute the entire pathway overestimated the results.
Aim
To synthesize clinical and scientific evidence regarding the instruments available to assess upper‐limb function in paediatric patients with neuromuscular disease (NMD).
Method
This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses and COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN) guidelines (Prospective Registry of Systematic Reviews no. CRD42020140343). Two independent reviewers searched the PubMed/MEDLINE, LILACS, Embase, and Scopus databases. Inclusion criteria were cross‐sectional or longitudinal studies or randomized controlled trials that used scales or questionnaires to assess upper‐limb function in paediatric patients with NMDs. The COSMIN Risk of Bias checklist and criteria for good measurement properties were applied to assess the methodological quality of the instruments.
Results
In total, 34 articles and 12 instruments were included. The Brooke Upper Extremity (n=16) and Performance of Upper Limb (PUL) (n=12) instruments were the most used tools. The PUL and Duchenne muscular dystrophy (DMD) Upper Limb patient‐reported outcome measures (PROMs) tested more measurement properties and provided higher methodological quality scores for patients with DMD. Likewise, the Revised Upper Limb Module (RULM) was the most suitable instrument for patients with spinal muscular atrophy. No instrument has been devised to assess upper‐limb function in patients with Charcot–Marie–Tooth disease and no other disease‐specific instruments were found.
Interpretation
The PUL, DMD Upper Limb PROM, and RULM are the most suitable instruments to assess upper‐limb function in the two most prevalent paediatric NMDs. The identified gaps and methodological flaws of the available instruments indicate a need to develop high‐quality instruments to assess other types of paediatric NMDs.
The most suitable observer–rater instrument to assess upper‐limb function in Duchenne muscular dystrophy (DMD) is the Performance of Upper Limb.
The most suitable observer–rater instrument to assess upper‐limb function in spinal muscular atrophy is the Revised Upper Limb Module.
The DMD Upper Limb patient‐reported outcome measure is recommended to assess the upper‐limb performance of patients with DMD.
Literature gaps and methodological flaws indicate the need to develop high‐quality instruments to assess other types of paediatric neuromuscular disease.
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