Validation of stroke-specific protocols for the 10-meter walk test and 6-minute walk test conducted using 15-meter and 30-meter walkways

ABSTRACT

Background: Stroke-specific protocols for the 10-meter and 6-minute walk tests that include instructions for people with aphasia, accessible walkway lengths, and allow provision of assistance to walk are needed to facilitate uptake in hospital settings.

Objectives: To estimate the test-retest reliability, measurement error, and construct validity of stroke-specific protocols for the 10-meter walk test (10mWT), and 6-minute walk test conducted using a 15-meter walkway (6MWT_15m) and 30-meter walkway (6MWT_30m), in people post-stroke.

Methods: A quantitative, cross-sectional study involving ambulatory people post-stroke was conducted.

Results: Data were collected from 21 and 20 participants at baseline and retest, respectively, 1–3 days apart. Mean age was 61 years, median time post-stroke was 134 days, and 90% had experienced an ischemic stroke. Performance on the 10mWT, 6MWT_15m, and 6MWT_30m across sessions yielded intraclass correlation coefficient (ICC_{2, 1}) estimates of test-retest reliability of 0.83, 0.97, 0.95, respectively, and minimal detectable change values at the 95% confidence level of 0.40m/s, 44.0m, and 67.5m, respectively. Pearson correlation coefficients were 0.80–0.95 (p < .001) between results on all three walk tests and 0.27–0.48 (p < .25) between walk test results and strength subscale scores on the Stroke Impact Scale.

Conclusions: Findings showed excellent test-retest reliability; measurement error values similar to current literature; and support for construct validity of the 10mWT, 6MWT_15m, and 6MWT_30m. Due to the shorter walkway, the 6MWT_15m may be more feasible to implement than the 6MWT_30m in hospital settings. A larger sample with more severe deficits is required to improve generalizability.

KEYWORDS:

• Stroke
• walk test
• gait speed
• walking capacity
• reliability
• measurement error
• validity

Acknowledgments

The primary author would like to thank the physical therapists and hospital staff that assisted in the conduct of this study. Thank you in particular to Carina Orschel, Heather Kwok, Sheila Furness, and Paula Shing from Bridgepoint-Sinai Health System, and Shannon Reid and Elizabeth Udler from West Park Healthcare Centre. Thanks as well to Gayatri Aravind, Kainat Bashir, and Stephanie Cheung for study support and facilitation. Finally, very special thanks to all patients for their time, energy, and optimism – this work would not be possible without them.

Supplementary material

Supplemental materials for this article can be accessed here.

Additional information

Funding

Funding for this project is provided by the Canadian Institutes of Health Research and the Heart & Stroke Foundation.