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Considerations for the Selection of Time-Limited Walk Tests Poststroke: A Systematic Review of Test Protocols and Measurement Properties.

Journal of neurologic physical therapy : JNPT
January 1, 2017
Nancy M Salbach et al. (8 authors)
Journal ArticleSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to synthesize the research literature on test protocols and measurement properties of time-limited walk tests in people poststroke.

Results Summary

The study found strong evidence of the reliability and construct validity of the 6-minute walk test (6MWT) poststroke, with moderate-to-strong correlations between 6MWT distance and various functional measures. Protocol variations, such as walkway length and walking aid, influenced performance, highlighting the need for standardized protocols.

Population

People poststroke (acute phase <1 month and beyond).

Effective Dosage

Not applicable (walk tests, not a supplement).

Duration

Not specified (systematic review of existing studies).

Interactions

None mentioned.

Extracted Claims (12)
InterventionDirectionEndpointPopulationDosageImpactClaim #
6-minute walk test (6MWT)
neutral
performance
people poststroke
-
influenced
#1
Walkway length
neutral
6MWT performance
people poststroke
-
influenced
#2
Walking aid
neutral
6MWT performance
people poststroke
-
influenced
#3
Turning direction
no change
6MWT performance
people poststroke
-
did not influence
#4
12MWT
neutral
Intraclass correlation coefficients
people poststroke
0.68 to 0.71
reliability
#5
2-, 3-, 5- and 6MWT
neutral
Intraclass correlation coefficients
people poststroke
0.80 to 1.00
reliability
#6
2MWT
neutral
-
people poststroke
11.4 m
Minimal detectable change values at the 90% confidence level
#7
5MWT
neutral
-
people poststroke
24.4 m
Minimal detectable change values at the 90% confidence level
#8
6MWT
neutral
-
people poststroke
27.7 to 52.1 m
Minimal detectable change values at the 90% confidence level
#9
6MWT
neutral
distance and balance, motor function, walking speed, mobility, and stair capacity
people poststroke
-
Moderate-to-strong correlations (≥0.5)
#10
5MWT
neutral
performance and walking speed/independence
people poststroke
-
Moderate-to-strong correlations
#11
12MWT
neutral
performance and balance, motor function, and walking speed
people poststroke
-
Moderate-to-strong correlations
#12
Abstract

BACKGROUND AND PURPOSE: Systematic reviews of research evidence describing the quality and methods for administering standardized outcome measures are essential to developing recommendations for their clinical application. The purpose of this systematic review was to synthesize the research literature describing test protocols and measurement properties of time-limited walk tests in people poststroke. METHODS: Following an electronic search of 7 bibliographic data-bases, 2 authors independently screened titles and abstracts. One author identified eligible articles, and performed quality appraisal and data extraction. RESULTS: Of 12 180 records identified, 43 articles were included. Among 5 walk tests described, the 6-minute walk test (6MWT) was most frequently evaluated (n = 36). Only 5 articles included participants in the acute phase (<1 month) poststroke. Within tests, protocols varied. Walkway length and walking aid, but not turning direction, influenced 6MWT performance. Intraclass correlation coefficients for reliability were 0.68 to 0.71 (12MWT) and 0.80 to 1.00 (2-, 3-, 5- and 6MWT). Minimal detectable change values at the 90% confidence level were 11.4 m (2MWT), 24.4 m (5MWT), and 27.7 to 52.1 m (6MWT; n = 6). Moderate-to-strong correlations (≥0.5) between 6MWT distance and balance, motor function, walking speed, mobility, and stair capacity were consistently observed (n = 33). Moderate-to-strong correlations between 5MWT performance and walking speed/independence (n = 1), and between 12MWT performance and balance, motor function, and walking speed (n = 1) were reported. DISCUSSION AND CONCLUSIONS: Strong evidence of the reliability and construct validity of using the 6MWT poststroke exists; studies in the acute phase are lacking. Because protocol variations influence performance, a standardized 6MWT protocol poststroke for use across the care continuum is needed.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A150).

Medical Subject Headings (MeSH)
Clinical ProtocolsHumansStrokeStroke RehabilitationWalk Test
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality78/10
Citation Metrics
Total Citations40
Citations/Year5.0
Relative Citation Ratio2.91
NIH Percentile84.3%
Research Impact Scores
APT Score0.95
Weight Score2.06
Normalized Score0.70
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Considerations for the Selection of Time-Limited Walk Tests ... | Panacea Index