Reliability and concurrent validity of standardized walking obstacle course test in people with stroke
Shamay S.M. Ng, Sunny C.L. Chan, Alexis K.Y. Chan, Hephzibah H.Y. Chung, Navis K.W. Lee, Anson T.S. Ngan, Mimi M.Y. Tse
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), Hong Kong. E-mail: Shamay.Ng@polyu.edu.hk
DOI: 10.2340/16501977-2265
Abstract
Objectives: To investigate: (i) the intra-rater, inter-rater and test-retest reliabilities of completion times and step counts on the Standardized Walking Obstacle Course test (SWOC); (ii) correlations between SWOC scores and stroke-specific impairments; (iii) the cut-off SWOC completion times and step counts for distinguishing differences in obstacle negotiation ability in people with chronic stroke and healthy older adults.
Design: Cross-sectional study.
Setting: University-based rehabilitation centre.
Subjects: Twenty-nine people with stroke and 30 healthy older adults.
Methods: SWOC completion times and step counts were measured under 3 conditions: (i) normal walking; (ii) walking with a tray; and (iii) walking with dark-glasses. The Fugl-Meyer Assessment of lower extremity, the Five-Times-Sit-to-Stand Test, the Berg Balance Scale, the Timed Up and Go Test (TUG), and the Community Integration Measure questionnaire, were also administered.
Results: SWOC completion times and step counts showed very satisfactory to excellent reliabilities (intraclass correlation coefficient; ICC = 0. 851–0. 993). TUG times correlated significantly with SWOC completion times and step counts under the 3 conditions (r = 0. 586–0. 815, p < 0. 001). SWOC completion times of 14. 73–16. 00 s and step counts of 23. 06–24. 13, depending on different walking conditions, were able to discriminate between stroke survivors and healthy older adults.
Conclusion: The SWOC is a reliable clinical tool for assessing obstacle negotiation ability in people with stroke.
Lay Abstract
The Standardized Walking Obstacle Course (SWOC) can be used to assess obstacle negotiation ability in stroke survivors. The objectives of this study were to determine the consistency of SWOC, how well performance in the SWOC relates to leg motor function, and the ability of the SWOC to distinguish stroke survivors from healthy older adults. Twenty-nine stroke survivors and 30 healthy older adults were assessed in a university-based rehabilitation centre.The results showed that SWOC completion times and step counts were highly consistent throughout the trials. The results were highly related to leg motor function, and could distinguish between stroke survivors and healthy older adults. The SWOC is a reliable clinical tool for assessing obstacle negotiation ability in people with stroke.
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