Test–retest reliability of the 10‐metre fast walk test and 6‐minute walk test in ambulatory school‐aged children with cerebral palsy

Short‐term test‐retest reliability of the 10‐metre fast walk test (10mFWT) and 6‐minute walk test (6MWT) was evaluated in 31 ambulatory children with cerebral palsy (CP), with subgroup analyses in Gross Motor Function Classification System (GMFCS) Levels I (n=9), II (n=8), and III (n=14). Sixteen females and 15 males participated, mean age 9 years 5 months (SD 3y 7mo, range 4y 3mo‐18y 2mo). Twenty had spastic diplegia, while the others had another form of CP. Retest interval varied from 1 to 4 weeks (mean 10.6d [SD 6.4]). Intraclass correlation coefficients (ICCs) estimated reliability. The 10mFWT ICC was 0.81 (95% confidence interval [CI] 0.65–0.90) across participants, and >0.59 in GMFCS subgroups (95% CI lower bound >0.01). The 6MWT ICC was 0.98, and >0.90 in GMFCS subgroups (95% CI lower bound >0.64). Bland‐Altman plots indicated bias towards higher 6MWT retest distances in GMFCS Level I. Minimum detectable change (95% CI) was 61.9, 64.0, and 47.4m for the 6MWT within GMFCS Levels I, II, and III respectively. The conclusion is that while the 10mFWT showed inadequate test‐retest reliability given its wide 95% CI, the 6MWT demonstrated good to excellent reliability. Investigation of the need for a practice walk when administering the 6MWT with children in GMFCS Level I is recommended to establish their fastest pace.

[1]  G Atkinson,et al.  Statistical Methods For Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine , 1998, Sports medicine.

[2]  E. Zwick,et al.  Intrasubject repeatability of gait analysis data in normal and spastic children. , 2000, Clinical biomechanics.

[3]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[4]  D. Wade,et al.  Validity and reliability comparison of 4 mobility measures in patients presenting with neurologic impairment. , 2001, Archives of physical medicine and rehabilitation.

[5]  Cynthia D. Brown,et al.  Minimal Clinically Important Differences in the Six-Minute Walk Test and the Incremental Shuttle Walking Test , 2005, COPD.

[6]  P. Stratford Getting More from the Literature: Estimating the Standard Error of Measurement from Reliability Studies , 2004 .

[7]  R. Palisano,et al.  Development and reliability of a system to classify gross motor function in children with cerebral palsy , 1997, Developmental medicine and child neurology.

[8]  C. Buckon,et al.  Comparison of three ankle-foot orthosis configurations for children with spastic diplegia. , 2004, Developmental medicine and child neurology.

[9]  C. Buckon,et al.  Comparison of three ankle-foot orthosis configurations for children with spastic hemiplegia. , 2007, Developmental medicine and child neurology.

[10]  H. So,et al.  The six-minute walk test in healthy children: reliability and validity , 2005, European Respiratory Journal.

[11]  Volker Dietz,et al.  Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests. , 2005, Archives of physical medicine and rehabilitation.

[12]  M. Watson Refining the ten-metre walking test for use with neurologically impaired people , 1992 .

[13]  R. C. Tsang Reference Values for 6-Minute Walk Test and Hand-Grip Strength in Healthy Hong Kong Chinese Adults , 2005 .

[14]  S. Naumann,et al.  Evaluation of selective dorsal rhizotomy for the reduction of spasticity in cerebral palsy: a randomized controlled trial , 1998, Developmental medicine and child neurology.

[15]  M. Eliasziw,et al.  Sample size requirements for reliability studies. , 1987, Statistics in medicine.

[16]  K. White,et al.  Validity and responsiveness of the 6 minute walk test for people with fibromyalgia. , 2000, The Journal of rheumatology.

[17]  E. Waclawski Health Measurement Scales—A Practical Guide to Their Development and Use , 2010 .

[18]  K. Mossberg,et al.  Reliability of a Timed Walk Test in Persons with Acquired Brain Injury , 2003, American journal of physical medicine & rehabilitation.

[19]  T. Takken,et al.  Reliability for Running Tests for Measuring Agility and Anaerobic Muscle Power in Children and Adolescents with Cerebal Palsy , 2007, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[20]  M. Joswiak,et al.  A six-minute walk test for assessing exercise tolerance in severely ill children. , 1996, The Journal of pediatrics.

[21]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[22]  T. Takken,et al.  Physiologic response of the six-minute walk test in children with juvenile idiopathic arthritis. , 2005, Arthritis and rheumatism.

[23]  S. Ristanis,et al.  Botulinum A toxin for treatment of lower limb spasticity in cerebral palsyGait analysis in 49 patients , 2003, Acta orthopaedica Scandinavica.

[24]  B Shea,et al.  Minimal clinically important differences: review of methods. , 2001, The Journal of rheumatology.

[25]  T. Takken,et al.  Validity of the 6-minute walking test in juvenile idiopathic arthritis. , 2005, Arthritis and rheumatism.

[26]  P. Goldie,et al.  Systematic and random error in repeated measurements of temporal and distance parameters of gait after stroke. , 1997, Archives of physical medicine and rehabilitation.

[27]  R. D. de Bie,et al.  Test–re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study , 2004, Brain injury.

[28]  L. Pfalzer,et al.  Reliability of Four Functional Tests and Rating of Perceived Exertion in Persons with Multiple Sclerosis , 2006 .