No abstract

Background/ObjectiveIn the field of Physical Medicine and Rehabilitation, it is essential to measure individual functional capacity, which could be evaluated through walking tests. Aside from the commonly used six minutes walking test (6MWT), four meter gait speed (4MGS) are widely used for its practicality. This study aimed to assess the agreement between 4 MGS and the 6MWT in Indonesian healthy adults.MethodsThis agreement analysis study had recruited 61 healthy and sedentary Indonesians aged 18 until 50 years old, and they were instructed to perform three tests, namely 6MWT and 4MGS with six meters and eight meters track. These gait speed were then compared to assess validity.ResultsMean gait speed results for males in 6MWT is 1.602 m/s, whereas 4MGS in six meter track is 2.114 m/s and similarly 2.108 m/s in the eight meter track. Females on the other hand, achieved 1.462 m/s for 6MWT, 1.908 m/s and 1.986 m/s for 4MGS in six and eight meter simultaneously. Bland Altman Agreement test between the 6MWT and 4MGS shows scatter dots with close limit of agreement, thus showing a good agreement between the 6MWT and 4 MGS with both tracks.DiscussionBoth track length of 4 MGS were in a good agreement with 6MWT for functional capacity assessment.ConclusionsIn response to the COVID-19 pandemic era, shorter track of 4MGS (six meters) can be feasibly utilized. It is evident that shorter duration and track will boost the tests practicality in assessing functional capacity for both inpatient and outpatient settings.

In facilities where a track required is not available for gait speed test, a simpler method using a shorter track and test duration is needed. One of such methods is the 4-meter gait speed. This study aimed to determine the cut off values for 4MGS and its correlation with the 6-minute walk test (6MWT), a more common functional performance test with shorter track and time. Data for this study were collected at the Department of Rehabilitation of Dr. Cipto Mangunkusumo General Hospital during the period of August 2016 to March 2017. The consecutive sampling approach was used to recruit healthy Indonesian adults (n=61) aged 18–50 years into this cross sectional study. The anthropometric and respiratory variables were measured as descriptive data and the cut-off values were determined by calculating the mean 4-meter gait speed (4MGS)-2SD for each gender. The 6MWT was performed afterwards to assess the correlation between 4MGS and 6-minute walk distance (6MWD). Results presented a mean 4MGS value of 2.114±0.309 m/s (male) and 1.908±0.227m/s (female) with the cut-off values for normal gait speed of 1.496 m/s and 1.454m/s for male and female, respectively. Factors affecting 4MGS were body height, body weight, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1). The 4MGS is only shown to be weakly correlated with 6MWD (r=0.314, p=0.014). The cut-off values for 4MGS can be used as a reference to assess the normality of gait speed as a parameter of functional mobility in healthy Indonesian adults and should be used in adjunct to 6MWT to represent a comprehensive functional capacity status.

Walking is an essential component of daily life and studies have shown the growing number of clinicians performing walking tests in their daily practice. This study is aimed to assess the validity and reliability of the Four-Meter Gait Speed (4MGS) test for healthy Indonesian adults (Mongoloid race). Data collection were conducted at the Rehabilitation Department of Dr. Cipto Mangunkusumo General Hospital during the period of August 2016 to March 2017. Two observers and two trials were involved in measuring the gait speed in the 4MGS test with a 6 meter track. All accumulated data were analyzed for validity using the Bland-Altman test, while test re-test reliability was done using Cronbach's alpha for internal consistency. Sixty-one subjects were involved in this study. There were no significant differences in inter-trial comparison from both observers (P=0.262 and P=0.954). Similarly, intra-observer walking speed comparison in both trials were also not significantly different (P=0.117 and P=0.869). The intraclass correlation coefficient (ICC) value between the first and second tests from observer I was 0.839 (Cronbach Alpha,0.911) while the value for observer II was 0.902 (Cronbach Alpha, 0.948). The ICC value between observer I and II in the first trial was 0.906 (Cronbach Alpha, 0.950); whereas the second trial demonstrated a value of 0.890 (Cronbach Alpha, 0.941). Thus, the 6 meter track 4MGS has a good validity and reliability for healthy Indonesian adults. It is expected that the walking speed from this study can be used for Mongoloid race living in other countries and the 4MGS can become an alternative speed-based walk test, especially during COVID-19 pandemic, due to its practicality in measuring functional capacity in a shorter duration.