Reliability, Validity, and Sensitivity to Change of the Lower Extremity Functional Scale in Individuals Affected by Stroke

Verheijde, Joseph L.; White, Fred; Tompkins, James; Dahl, Peder; Hentz, Joseph G.; Lebec, Michael; Cornwall, Mark

doi:10.1016/j.pmrj.2013.07.001

Cited by 19 publications

(19 citation statements)

References 34 publications

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“…The 6MWT was performed: to induce fatigue [ 124 ]; over a variety of obstacles such as foam mats and purpose built ramps [ 23 ]; and in nonstandard locations such as outdoors [ 30 , 130 , 138 ] including suburban streets or shopping centres [ 38 ]. Walking distances achieved in outdoor locations ranged from 175 ± 67 m to 463 ± 84 m [ 36 ], with participants walking 234 ± 66.5 m in the shopping centre [ 127 ]. Stroke survivors in two intervention groups who walked over foam mats and purpose built ramps [ 10 ] walked 102.6 ± 64.5 m and 78.5 ± 61.3 m.…”

Section: Resultsmentioning

confidence: 99%

“…Only 25 of the 127 studies made a reference to the ATS guidelines for the 6MWT, with only nine of these clearly reporting the use of a 30 m walkway. Although referencing the ATS standards, six studies modified the protocol with variations including the use of a 25 m walkway [ 133 ], a 33 m walkway [ 127 ], a 50 m walkway [ 96 , 128 ], a 100 m walkway [ 75 ], and a 30 m oval course [ 48 ]. Overall, 67 studies provided a description of the walkway whereas 60 studies did not provide any description of the length or shape of the walkway used.…”

Section: Resultsmentioning

confidence: 99%

“…Of those studies that reported on the encouragement given throughout the test, 42% provided encouragement and 58% provided no verbal encouragement or feedback. The guidelines specify that the 6MWT should be performed indoors; however several studies reported using the 6MWT in different environments such as outdoors [ 36 , 124 , 126 ] including suburban streets and in shopping centres [ 127 ]. Although these trials were excluded from the meta-analysis, the exact implications of performing the 6MWT in different locations are unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Carvalho et al [ 138 ] directly compared distanced achieved indoors and outdoors, concluding that stroke survivors in Group B (self-selected walking speed ≥0.8 m · s −1 ) achieved a greater distance in the outdoor setting, whereas for those in Group A (self-selected walking speed <0.8 m · s −1 ) there was no difference. It has also been suggested that gait parameters do not differ in stroke survivors when walking in different environments [ 127 ]. This is another factor that should be considered when interpreting the results reported from the 6MWT.…”

Section: Discussionmentioning

confidence: 99%

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Protocol Variations and Six-Minute Walk Test Performance in Stroke Survivors: A Systematic Review with Meta-Analysis

Dunn

Marsden

Nugent

et al. 2015

Stroke Research and Treatment

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Objective. To investigate the use of the six-minute walk test (6MWT) for stroke survivors, including adherence to 6MWT protocol guidelines and distances achieved. Methods. A systematic search was conducted from inception to March 2014. Included studies reported a baseline (intervention studies) or first instance (observational studies) measure for the 6MWT performed by stroke survivors regardless of time after stroke. Results. Of 127 studies (participants n = 6,012) that met the inclusion criteria, 64 were also suitable for meta-analysis. Only 25 studies made reference to the American Thoracic Society (ATS) standards for the 6MWT, and 28 reported using the protocol standard 30 m walkway. Thirty-nine studies modified the protocol walkway, while 60 studies did not specify the walkway used. On average, stroke survivors walked 284 ± 107 m during the 6MWT, which is substantially less than healthy age-matched individuals. The meta-analysis identified that changes to the ATS protocol walkway are associated with reductions in walking distances achieved. Conclusion. The 6MWT is now widely used in stroke studies. The distances achieved by stroke patients indicate substantially compromised walking ability. Variations to the standard 30 m walkway for the 6MWT are common and caution should be used when comparing the values achieved from studies using different walkway lengths.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Protocol Variations and Six-Minute Walk Test Performance in Stroke Survivors: A Systematic Review with Meta-Analysis

Dunn

Marsden

Nugent

et al. 2015

Stroke Research and Treatment

View full text Add to dashboard Cite

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“…This compensation increases energy expenditure as muscles like the glutes, quadriceps and gastrocnemius and soleus have to be active to provide dynamic support to the joints. 28,29) The LEFS demonstrated improvement as MDC is 9 points, which was achieved as subject's score went from 18/80 to 27/80. 14) As a result, we believe that a significant reduction of pain may be positively transferred to utilize muscle strength so that the subject showed a significantly better functional performance.…”

Section: 6)mentioning

confidence: 97%

A Progressive Physical Therapy Plan of Care for a Patient with Bilateral Knee Pain due to Degenerative Joint Disease following a Cerebral Vascular Accident: A Case Report

Soo¹

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Purpose The purpose of this case report was to describe the effects of a 6-week physical therapy program consisting of strengthening exercises, balance training, stretching and self-managing education of an adult with bilateral knee osteoarthritis (OA) and cerebral vascular accident (CVA) during an outpatient episode of care. Methods The individual was a 62-year-old female with a history of bilateral knee osteoarthritis and recent history of mild CVA. The subject participated in a 6-week physical therapy program consisting of strengthening exercises, balance training, stretching and self-managing education. The subject was seen 3 times a week, with a day of recovery between each therapy session. The Lower Extremity Functional Scale (LEFS), Berg Balance Scale (BBS), Manual Muscle Test (MMT), Time Up and Go (TUG), Numeric Pain Rating Scale (NPRS), 10-Meter Walk Test (10MWT) and Five Time Sit to Stand Test (FTSST) were used to assess progress in this subject. Results Outcome measures were used at evaluation and were administered every two weeks. The Timed Up and Go improved from 22 seconds to 12 seconds. The Five Time Sit to Stand Test improved from 39 seconds to 16 seconds, while the Berg Balance Scale improved from 43 to 52 points. Lower Extremity Functional Scale improved by 9 points and gait speed improved by 0.27m/s. The Numeric Pain Rating Scale was monitored throughout the course of treatment, which served as a guide that pain was not exacerbated and that the exercise program was well tolerated by the subject. Conclusion This case report describes an exercise program that significantly decreasing pain, while improving balance, functional strength, and gait kinematics with no adverse effect in a subject with bilateral knee osteoarthritis with recent mild CVA. We believe that a significant reduction of pain induces a better functional performance in the subject with OA and CVA.

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Development of a candidate item bank for measuring mobility of lower limb orthosis users

Balkman

Morgan

Amtmann

et al. 2023

PM&R

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Background Orthoses are often prescribed to improve mobility of people with chronic health conditions that affect lower limb function. Patient‐reported survey instruments can be used to measure aspects of mobility that cannot be easily assessed in clinical or research settings. A population‐specific item bank could be designed to measure aspects of mobility that are most important to lower limb orthosis users and used to evaluate the effects of orthoses. Objective To develop items for a new survey instrument to measure mobility of lower limb orthosis users. Design Survey items were developed using a qualitative item review process. Setting Focus groups were held by video conferencing. Cognitive interviews were conducted by telephone. Participants Focus group and cognitive interview participants were adults with at least 6 months of experience using a lower limb orthosis that extended from the foot to a level above the ankle. Methods Research methods included focus groups with lower limb orthosis users, an item generation and reduction process that involved a stakeholder advisory panel, and cognitive interviews with target respondents. Results A total of 1180 extant items were identified in a literature review. Focus group participants (n = 29) provided feedback that informed the suitability of a construct definition and conceptual model. An advisory panel contributed to the selection of 118 candidate items for measuring orthotic mobility. Feedback from cognitive interview participants (n = 30) informed removal or revision of problematic items, resulting in a candidate bank of 100 mobility items. Conclusions The rigorous qualitative methods applied here resulted in a large set of candidate items that spanned a range of situations relevant to moving with a lower limb orthosis. Next steps include administration of the candidate items to a large sample of lower limb orthosis users and calibration of the item bank.

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Reliability, Validity, and Sensitivity to Change of the Lower Extremity Functional Scale in Individuals Affected by Stroke

Cited by 19 publications

References 34 publications

Protocol Variations and Six-Minute Walk Test Performance in Stroke Survivors: A Systematic Review with Meta-Analysis

Protocol Variations and Six-Minute Walk Test Performance in Stroke Survivors: A Systematic Review with Meta-Analysis

A Progressive Physical Therapy Plan of Care for a Patient with Bilateral Knee Pain due to Degenerative Joint Disease following a Cerebral Vascular Accident: A Case Report

Development of a candidate item bank for measuring mobility of lower limb orthosis users

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