The 3-Meter Backward Walk Test (3MBWT): Reliability and validity in individuals with subacute and chronic stroke

ABSTRACT

Introduction

Backward walking (BW) is an important gait adaptation and BW speed may be an important indicator of walking function and fall risk. However, the measurement characteristics of a standardized assessment of BW post-stroke have not been fully established.

Objectives

To determine intra- and interrater reliability, concurrent validity and minimal detectable change (MDC) scores for the 3-Meter Backward Walk Test (3MBWT) post-stroke.

Methods

Thirty-four individuals with subacute and 29 individuals with chronic stroke participated. Two trials of comfortable BW was measured over a total distance of 5-meters, while speed was calculated during the middle 3-meters of the walking distance. Intra and interrater reliability were determined by comparing the two trials from one rater and simultaneous assessment of two raters, respectively. Two additional trials were performed and BW speed was calculated using 3MBWT and an instrumented walkway to determine concurrent validity. Intraclass correlation coefficients (ICC) estimated reliability and validity. The MDC was calculated from the standard error of measurement.

Results

Excellent ICC values were obtained for the 3MBWT in the subacute (interrater: ICC_2,1 = 0.99; intrarater: ICC_2,1 = 0.96; validity: ICC_2,1 = 0.96) and chronic (interrater: ICC_2,1 = 0.99; intrarater: ICC_2,1 = 0.94; validity: ICC_2,1 = 0.97) groups. The MDC was 0.07 m/s (subacute) and 0.11 m/s (chronic).

Conclusions

Establishment of the 3MBWT as a reliable and valid measure in assessing BW speed is an important addition to the assessment toolbox for rehabilitation post-stroke.

KEYWORDS:

• Backward walking
• stroke
• reliability
• validity

Acknowledgments

The authors thank the study participants, Brooks Rehabilitation, the Brooks-UF PHHP Research Collaboration, and team members of the Brooks Clinical Research and Motion Analysis Centers. This work was supported by the VA Rehabilitation Research & Development Service under Grant #N2004-R; VA Rehabilitation Research & Development under Grant #B3336-P

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the VA Rehabilitation Research and Development Service [N2004-R, B3336-P].