Inter-rater reliability and agreement of 6 Minute Walk Test and 10 Meter Walk Test at comfortable walk speed in patients with acute stroke

Busk, Henriette; Holm, Pætur Mikal; Skou, Søren Thorgaard; Seitner, Simon; Siemsen, Troels; Wienecke, Troels

doi:10.1080/09593985.2022.2030830

Cited by 15 publications

(10 citation statements)

References 43 publications

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“… 38 Ten-meter walk test was used to measure gait speed. 39 40 Those tests demonstrated good inter-rater reliability in previous studies. 36 37 38 39 40 …”

Section: Methodsmentioning

confidence: 62%

“…Although the same assessor did not perform the assessments in many cases, each outcome measure was shown to have good inter-rater reliability in previous studies. 33 34 36 37 38 39 40 Baseline assessment was performed upon initiation of the exercise program in the PT room and included an evaluation of physical status, cognitive function, and psychiatric status. Cognitive function was evaluated using the Mini-Mental Status Examination (MMSE), and self-assessment of mood was conducted using the PHQ-9.…”

Section: Methodsmentioning

confidence: 99%

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Comprehensive Rehabilitation in Severely Ill Inpatients With COVID-19: A Cohort Study in a Tertiary Hospital

Woo

Lee

et al. 2022

J Korean Med Sci

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Background This study aimed to investigate the effects of comprehensive rehabilitation management on functional recovery and examine the correlation between clinical parameters and improvements in functional outcomes in severe-to-critical inpatients with coronavirus disease 2019 (COVID-19) in a tertiary hospital. Methods Post-acute COVID-19 patients who had a World Health Organization (WHO) ordinal scale of 5–7, underwent intensive care, and received comprehensive rehabilitation management, including exercise programs, nutritional support, dysphagia evaluation, and psychological care were included. The appendicular skeletal muscle mass index (SMI), Medical Research Council sum score, handgrip strength, number of repetitions in the 1-minute sit-to-stand test, gait speed, Berg Balance Scale (BBS), and Functional Ambulation Classification (FAC) were evaluated at hospital stay, discharge, and 1-month follow-up. The correlation between the rehabilitation dose and improvement in each outcome measure was analyzed. Results Overall, 37 patients were enrolled, of whom 59.5% and 32.4% had a score of 6 and 7 on the WHO ordinal scale, respectively. Lengths of stay in the intensive care unit and hospital were 33.6 ± 23.9 and 63.8 ± 36.5 days. Outcome measures revealed significant improvements at discharge and 1-month follow-up. The SMI was significantly increased at the 1-month follow-up (6.13 [5.24–7.76]) compared with that during the hospital stay (5.80 [5.39–7.05]). We identified dose-response associations between the rehabilitation dose and FAC (ρ = 0.46) and BBS (ρ = 0.50) scores. Patients with older age, longer hospitalization, longer stay at the intensive care unit, longer duration of mechanical ventilation, tracheostomy, a more depressive mood, and poorer nutritional status revealed poorer improvement in gait speed at the 1-month follow-up. Conclusion Comprehensive rehabilitation management effectively improved muscle mass, muscle strength, and physical performance in severe-to-critical COVID-19 patients. Dose-response relationship of rehabilitation and functional improvement emphasizes the importance of intensive post-acute inpatient rehabilitation in COVID-19 survivors. Trial Registration ClinicalTrials.gov Identifier: NCT05104411

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“… 38 Ten-meter walk test was used to measure gait speed. 39 40 Those tests demonstrated good inter-rater reliability in previous studies. 36 37 38 39 40 …”

Section: Methodsmentioning

confidence: 62%

Section: Methodsmentioning

confidence: 99%

Comprehensive Rehabilitation in Severely Ill Inpatients With COVID-19: A Cohort Study in a Tertiary Hospital

Woo

Lee

et al. 2022

J Korean Med Sci

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“…TMS is thus a valid internal measure in the acute phase, as opposed to physical tests in the same phase which rarely are. 26 …”

Section: Discussionmentioning

confidence: 99%

“…This internal measure is not affected by external factors like stress, fatigue or cognitive disorders which can affect physical performance outcomes. 26 …”

Section: Clinical Interpretationmentioning

confidence: 99%

“… 23 - 25 However, the reliability and agreement of TMS in acute ischemic stroke remain unexplored. A previous study found that the measurement error of functional performance tests in the acute phase post stroke was high, likely due to the quickly changing neurological impairments, 26 suggesting that the reliability and agreement of TMS outcome measurements might also be affected in the acute phase.…”

Section: Introductionmentioning

confidence: 99%

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Test-Retest Reliability and Agreement of Single Pulse Transcranial Magnetic Stimulation (TMS) for Measuring Activity in Motor Cortex in Patients With Acute Ischemic Stroke

et al. 2022

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Background: Transcranial magnetic stimulation (TMS) is often used to examine neurophysiology. We aimed to investigate the inter-rater reliability and agreement of single pulse TMS in hospitalised acute ischemic stroke patients. Methods: Thirty-one patients with first-time acute ischemic stroke (median age 72 (IQR 64-75), 35% females) underwent TMS motor threshold (MT) assessment in 4 muscles bilaterally, conducted by 1 of 2 physiotherapists. Test-retest reliability was evaluated using a two-way random effects model (2,1) absolute agreement-type Interclass Correlation Coefficient (ICC). Standard Error of Measurement (SEM) and Smallest Detectable Change (SDC) were used to evaluate agreement. Results: Reliability, SEM, and SDC of TMS was found to be moderate in right opponens pollicis (0.78 [CI 95% 0.55-0.89], SEM: 4.51, SDC: 12.51), good in right vastus medialis and tibial anterior (0.88 [CI 95% 0.72-0.96], SEM: 2.89, SDC: 8.01 and 0.88 [CI 95% 0.76-0.94], SEM: 2.88, SDC: 7.98 respectively), and excellent in right and left biceps brachii (0.98 [CI 95% 0.96-0.99], SEM: 1.79 SDC: 4.96, and 0.94 [CI 95% 0.89-0.97], SEM: 2.17 SDC: 6.01), opponens pollicis (0.92 [CI 95% 0.83-0.96], SEM: 2.68 SDC: 8.26, vastus medialis (0.92 [CI 95% 0.84-0.96], SEM: 2.87 SDC: 7.95), and tibial anterior (0.93 [CI 95% 0.86-0.96], SEM: 2.51 SDC: 6.95). Conclusion: The TMS demonstrated moderate to excellent inter-rater reliability confirming the ability of these measures to reliably discriminate between individuals in the current study sample. Improvements of less than 4.96 to 12.51 could be a result of measurement error and may therefore not be considered a true change.

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Estimation of minimal clinically important difference for 6‐minute walking distance in patients with acute stroke using anchor‐based methods and credibility instruments

Hayashi,

Takeda,

Miyata

et al. 2024

Physiotherapy Res Intl

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Background and PurposeStroke impairs a patient's ability to walk. In patients with acute stroke, a 6‐min walking distance (6MWD) is recommended to assess walking function. Minimal clinically important difference (MCID) is used to determine the effectiveness of rehabilitation; however, the MCID for 6MWD has not been adequately validated. This study aimed to estimate the MCID of 6MWD, a measure of walking endurance, in patients with acute stroke using anchor‐based methods.MethodsBased on the change in 6MWD from baseline to the follow‐up measurement 2 weeks later, the MCID was estimated using anchor‐based methods (receiver operator operating characteristic curves, predictive and adjustment models) with a patient‐ and therapist‐rated global rating of change scale (p‐GRC, t‐GRC) as external anchors. The accuracy of “meaningful change” was estimated from the area under the curve. Using MCID's credibility instruments, the credibility of each anchor was evaluated. Using the credibility instrument, high credibility was defined as satisfying 3/5 of the Core criteria and 6/9 of all criteria.ResultsThe analysis included 58 patients. The MCID for each anchor was 78.7–100.0 m for p‐GRC, and 95.2–99.5 m for t‐GRC. The p‐GRC demonstrated excellent accuracy (area under the curve >0.8). With p‐GRC as anchors, over 50% of patients showed improvement. The p‐GRC satisfied the core criterion of 3/5 and all criteria of 6/9 on the reliability instrument. The t‐GRC demonstrated low reliability and satisfied the core criterion of 2/5 and all criteria of 3/9.DiscussionSince the percentage of improved groups exceeded 50%, the adjusted model was useful in the anchor‐based method. Therapists may not accurately capture patient fatigue and subjective symptoms, potentially affecting the correlation between the 6MWD change score and the t‐GRC and, consequently, the reliability instrument. The p‐GRC showed high accuracy and reliability; therefore, the MCID was estimated to be 78.7 m.

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Inter-rater reliability and agreement of 6 Minute Walk Test and 10 Meter Walk Test at comfortable walk speed in patients with acute stroke

Cited by 15 publications

References 43 publications

Comprehensive Rehabilitation in Severely Ill Inpatients With COVID-19: A Cohort Study in a Tertiary Hospital

Comprehensive Rehabilitation in Severely Ill Inpatients With COVID-19: A Cohort Study in a Tertiary Hospital

Test-Retest Reliability and Agreement of Single Pulse Transcranial Magnetic Stimulation (TMS) for Measuring Activity in Motor Cortex in Patients With Acute Ischemic Stroke

Estimation of minimal clinically important difference for 6‐minute walking distance in patients with acute stroke using anchor‐based methods and credibility instruments

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