Assessing walking adaptability in children with cerebral palsy: validity and reliability of the walking adaptability ladder test for kids

ABSTRACT

Introduction

Assessing gait adaptation in children with cerebral palsy (CP) requires cost-effective and easily applicable methods.

Objective

To evaluate the reliability and validity of the Walking Adaptability Ladder Test for Kids (WAL-K) in assessing gait adaptation in children with CP.

Methods

Sixty-six participants (40 children with CP and 26 controls), aged 6–18 years, underwent WAL-K testing under single- and double-run conditions with video recording. Test-retest reliability, interrater reliability, concurrent validity, and known-group validity were assessed. Concurrent validity was assessed using the Timed Up and Go Test (TUGT), Four-Square Step Test (FSST), and Five Times Sit-to-Stand Test.

Results

Interrater intraclass correlation coefficients (ICC3,k) values were > 0.999 for the WAL-K single- and double-run tests. The test-retest reliability ICC3,k values were 0.988 for the WAL-K single-run, and 0.963, 0.962, and 0.963 for the WAL-K double-run (p < .05). WAL-K double-run showed a strong correlation with FSST (r = 0.791), while WAL-K single-run correlated weakly with TUGT (r = 0.394) (p < .01). Moderate correlations were observed between other tests (p < .01). Children with CP had higher scores in all WAL-K tests compared to controls (p < .001).

Conclusion

The WAL-K test demonstrated validity and reliability, making it suitable for clinical use without requiring specialized laboratory settings. It enables repeated assessments of gait adaptation in children with CP.

KEYWORDS:

• Cerebral palsy
• gait
• outcome measures
• reliability
• validity

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.