Distance-limited walk tests post-stroke: A systematic review of measurement properties1

Abstract

BACKGROUND: Improving walking capacity is a key objective of post-stroke rehabilitation. Evidence describing the quality and protocols of standardized tools for assessing walking capacity can facilitate their implementation. OBJECTIVE: To synthesize existing literature describing test protocols and measurement properties of distance-limited walk tests in people post-stroke. METHODS: Electronic database searches were completed in 2017. Records were screened and appraised for quality. RESULTS: Data were extracted from 43 eligible articles. Among the 12 walk tests identified, the 10-metre walk test (10mWT) at a comfortable pace was most commonly evaluated. Sixty-three unique protocols at comfortable and fast paces were identified. Walking pace and walkway surface, but not walkway length, influenced walking speed. Intraclass correlation coefficients for test-retest reliability ranged from 0.80–0.99 across walk tests. Measurement error values ranged from 0.04–0.40 and 0.06 to 0.20 for the 10mWT at comfortable and fast and paces, respectively. Across walk tests, performance was most frequently correlated with measures of strength, balance, and physical activity (r = 0.26-0.8, p < 0.05). CONCLUSIONS: The 10mWT has the most evidence of reliability and validity. Findings indicate that studies that include people with severe walking deficits, in acute and subacute phases of recovery, with improved quality of reporting, are needed.

Walking speed at the acute and subacute stroke stage: A descriptive meta-analysis

“…However, considering the heterogeneity of the subacute poststroke population, a selection bias in each study can be assumed. To limit the heterogeneity of WS assessments, we chose as primary criterion short-distance WS according the ten-meter walking test, which is considered the gold standard after stroke ( 22 ). For short-distance WS, we excluded other assessments ranging from the two-meter to the six-meter walking test and barefoot assessments.…”

“…Relationships between balance, cognition, autonomy and gait skills could not be assessed on secondary objectives because of missing data. In a recent meta-analysis of distance-limited walking tests after stroke, gait performance assessed by the ten-meter walking test was correlated with measures of strength, balance and physical activity ( r = 0.26–0.8, p < 0.05) ( 22 ). While the relationship between gait skills and cognitive ability had been assessed in the general population over the age of 65 years ( 62 ) and in acute stroke patients ( 63 ), it needs to be completed at the subacute stage of stroke in order to advance in the analysis.…”

“…Eligibility criteria were WS data from studies published between 2000 and 2021 to obtain a recent homogeneous population from stroke units after introduction of the thrombolysis and thrombectomy because these treatments have revolutionized poststroke prognosis ( 27 , 28 ), regardless of sample size to limit selection bias, with assessment of WS (ten-meter walking test for short distance and/or 6-min walking distance for long distance) within 6 months following a first ischemic and/or hemorrhagic stroke, and prior to any specific walking rehabilitation. We chose to focus on the ten-meter walking test because it is the only test with evidence of excellent reliability and construct validity in people with acute and subacute stroke (ASS) ( 22 ).…”

“…Walking speed (WS) is an important functional measure for vital status and gait ability after stroke ( 17 – 21 ). The comfortable ten-meter walking test is the gold standard assessment of short-distance WS in the stroke population ( 22 ). WS >0.80 m.s −1 (meters per second) is usually considered to be necessary for safe ambulation in daily activities, such as safely crossing a street ( 23 , 24 ).…”

Increasing Access to Task-Oriented Community-Based Exercise Programs Through Healthcare-Community Partnerships to Improve Function Post-Stroke: Feasibility of a 2-Group Randomized Controlled Trial Protocol

“…Explanatory outcomes: Balance, balance self-e cacy, lower limb strength, walking distance, comfortable walking speed, cognition, and depression were evaluated using the Berg balance scale (BBS) [38], activities-speci c balance con dence (ABC) scale [39], 30-second timed sitto-stand test (30-STS) [40], 6-minute walk test (6MWT) [41,42], 10-metre walk test (10mWT) [43], trail making test (TMT) [44], and geriatric depression scale-short version (GDS) [45], respectively.…”