Short-distance walking speed tests in people with Parkinson disease: reliability, responsiveness, and validity.

PURPOSE The aims of this study were to determine test-retest reliability and responsiveness of short-distance walking speed tests for persons with Parkinson disease (PD). Discriminant and convergent validity of walking speed tests were also examined. METHODS Eighty-eight participants with PD (mean age, 66 years) with mild to moderate severity (stages 1-4 on the Hoehn and Yahr Scale) were tested on medications. Measures of activity included the comfortable and fast 10-m walk tests (CWT, FWT), 6-min walk test (6MWT), mini balance evaluations systems test (mini-BEST Test), fear of falling (FoF), and the Activity-Specific Balance Confidence Scale (ABC). The mobility subsection of the PD quality of life-39 (PDQ39-M) served as a participation-based measure. RESULTS Test-retest reliability was high for both walking speed measures (CWT, ICC(2,1) = 0.98; FWT, ICC(2,1) = 0.99). Minimal detectable change (MDC(95)) for the CWT and FWT was 0.09 m/s and 0.13 m/s respectively. Participants at Hoehn & Yahr levels 3/4 demonstrated significantly slower walking speed with the CWT and FWT than participants at Hoehn & Yahr levels 1 and 2 (P < .01). The CWT and FWT were both significantly (P ≤ .002) correlated with all activity and participation-based measures. CONCLUSIONS Short-distance walking speed tests are clinically useful measures for persons with PD. The CWT and FWT are highly reliable and responsive to change in persons with PD. Short distance walking speed can be used to discriminate differences in gait function between persons with mild and moderate PD severity. The CWT and FWT had moderate to strong associations with other activity and participation based measures demonstrating convergent validity.

[1]  Donna Smith,et al.  Psychological Indicators of Balance Confidence: Relationship to Actual and Perceived Abilities , 1997 .

[2]  R. Fitzpatrick,et al.  The Parkinson's Disease Questionnaire (PDQ-39): development and validation of a Parkinson's disease summary index score. , 1997, Age and ageing.

[3]  L. Portney,et al.  Foundations of Clinical Research: Applications to Practice , 2015 .

[4]  T. Steffen,et al.  Testing functional performance in people with Parkinson disease. , 2005, Physical therapy.

[5]  Carolynn Patten,et al.  Reliability of gait performance tests in men and women with hemiparesis after stroke. , 2005, Journal of rehabilitation medicine.

[6]  I. Jonkers,et al.  Quantitative gait analysis in Parkinson's disease: comparison with a healthy control group. , 2005, Archives of physical medicine and rehabilitation.

[7]  J. Korpelainen,et al.  Recurrent falls and mortality in Parkinson’s disease: a prospective two‐year follow‐up study , 2011, Acta neurologica Scandinavica.

[8]  L. Tickle-Degnen,et al.  Profile of Functional Limitations and Task Performance Among People With Early- and Middle-Stage Parkinson Disease , 2011, Physical Therapy.

[9]  S. Rubin,et al.  Prognostic Value of Usual Gait Speed in Well‐Functioning Older People—Results from the Health, Aging and Body Composition Study , 2005, Journal of the American Geriatrics Society.

[10]  J Howland,et al.  Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). , 1998, The journals of gerontology. Series B, Psychological sciences and social sciences.

[11]  W. Miller,et al.  Measurement properties of the Activities-specific Balance Confidence Scale among individuals with stroke , 2005, Disability and rehabilitation.

[12]  Kristian Overgaard,et al.  Relations between 6 minute walking distance and 10 meter walking speed in patients with multiple sclerosis and stroke. , 2012, Archives of physical medicine and rehabilitation.

[13]  S. Fritz,et al.  White paper: "walking speed: the sixth vital sign". , 2009, Journal of geriatric physical therapy.

[14]  G M Earhart,et al.  Which measures of physical function and motor impairment best predict quality of life in Parkinson's disease? , 2011, Parkinsonism & related disorders.

[15]  Kevin Sykes,et al.  The validity and reliability of a 6-Metre Timed Walk for the functional assessment of patients with stroke , 2010, Physiotherapy theory and practice.

[16]  T. Steffen,et al.  Test-Retest Reliability and Minimal Detectable Change on Balance and Ambulation Tests, the 36-Item Short-Form Health Survey, and the Unified Parkinson Disease Rating Scale in People With Parkinsonism , 2008, Physical Therapy.

[17]  Richard W. Bohannon Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. , 1997, Age and ageing.

[18]  C. Nygren,et al.  The 39 item Parkinson’s disease questionnaire (PDQ-39) revisited: implications for evidence based medicine , 2007, Journal of Neurology, Neurosurgery, and Psychiatry.

[19]  S. Studenski,et al.  Gait speed and survival in older adults. , 2011, JAMA.

[20]  J. Summers,et al.  Temporal stability of gait in Parkinson's disease. , 1996, Physical therapy.

[21]  R. Craik,et al.  Detectable Changes in Physical Performance Measures in Elderly African Americans , 2010, Physical Therapy.

[22]  Gammon M Earhart,et al.  Factors Associated With Exercise Behavior in People With Parkinson Disease , 2011, Physical Therapy.

[23]  Gammon M Earhart,et al.  Utility of the Mini-BESTest, BESTest, and BESTest Sections for Balance Assessments in Individuals With Parkinson Disease , 2011, Journal of neurologic physical therapy : JNPT.

[24]  S. Haley,et al.  Interpreting change scores of tests and measures used in physical therapy. , 2006, Physical therapy.

[25]  R W Sattin,et al.  Associations of Demographic, Functional, and Behavioral Characteristics with Activity‐Related Fear of Falling Among Older Adults Transitioning to Frailty , 2001, Journal of the American Geriatrics Society.

[26]  G. Fulk,et al.  Test-Retest Reliability and Minimal Detectable Change of Gait Speed in Individuals Undergoing Rehabilitation After Stroke , 2006, Journal of neurologic physical therapy : JNPT.

[27]  G. Kwakkel,et al.  Measuring gait and gait-related activities in Parkinson's patients own home environment: a reliability, responsiveness and feasibility study. , 2005, Parkinsonism & related disorders.

[28]  J. Echternach,et al.  Test-Retest Reliability and Minimal Detectable Change Scores for the Timed " Up & Go " Test , the Six-Minute Walk Test , and Gait Speed in People With Alzheimer Disease , 2018 .

[29]  C. Jenkinson,et al.  The Parkinson's disease questionnaire , 1998 .

[30]  L. Russek Factors affecting interpretation of reliability coefficients. , 2004, The Journal of orthopaedic and sports physical therapy.

[31]  S. Studenski,et al.  Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults , 2006, Journal of the American Geriatrics Society.

[32]  L. Ada,et al.  Walking capacity in mild to moderate Parkinson's disease. , 2006, Archives of physical medicine and rehabilitation.

[33]  Paul Mathews,et al.  Sample Size Calculations: Practical Methods for Engineers and Scientists , 2010 .