Measurement properties of a 300-m community-based walking test incorporating environmental walking demands in individuals with subacute stroke.

IF 1.6 4区 医学 Q2 REHABILITATION
Jun Min Lee, Eun Joo Kim, Sung Phil Yang, Byung Ju Shin, Su Ji Choi, Seung Heun An
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引用次数: 0

Abstract

Background: Performance-based assessments reflecting environmental walking demands remain limited in subacute stroke rehabilitation.

Objective: To evaluate the measurement properties of a 300-m Community-Based Walking Test (CBWT) designed to reflect environmental walking demands in individuals with subacute stroke.

Methods: We retrospectively analyzed prospectively collected clinical data from 26 ambulatory individuals with subacute stroke (13 men and 13 women; mean age, 56.8 years [range, 26-81 years]) who completed the CBWT in both forward and reverse directions during rehabilitation. Assessments were performed at baseline and weeks 1, 2, and 4. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC2,1), standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman analysis. Responsiveness was assessed using standardized response mean (SRM) and effect size (ES), and convergent and longitudinal validity using Spearman correlations with gait, balance, and mobility measures.

Results: CBWT completion time demonstrated excellent test-retest reliability in both directions (ICC = 0.92-0.93; 95% CI = 0.83-0.96). SEM ranged from 30 to 31 s and MDC from 83 to 86 s. Four-week responsiveness was moderate to high (SRM = 0.91-1.01; ES = 0.53-0.55). CBWT completion time showed moderate to high correlations with gait speed (r =  -0.70 to -0.84), walking endurance (r =  -0.76 to -0.81), and mobility (r = 0.78-0.83). Variability was observed even among independently ambulatory participants.

Conclusion: The present findings provide preliminary evidence supporting the measurement properties of the CBWT in individuals with subacute stroke. The CBWT may provide complementary clinical information regarding walking performance under structured environmental demands beyond conventional indoor gait assessments, which may support the evaluation of environmental walking adaptation and inform clinical judgment regarding community mobility during rehabilitation and discharge planning.

包含亚急性脑卒中患者环境步行需求的300米社区步行试验的测量特性
背景:反映环境步行需求的基于性能的评估在亚急性卒中康复中仍然有限。目的:评估旨在反映亚急性脑卒中患者环境步行需求的300米社区步行测试(CBWT)的测量特性。方法:我们回顾性分析前瞻性收集的26例亚急性脑卒中患者的临床资料(男性13例,女性13例,平均年龄56.8岁[范围26-81岁]),这些患者在康复期间完成了正向和反向CBWT。在基线和第1、2和4周进行评估。采用类内相关系数(ICC2,1)、测量标准误差(SEM)、最小可检测变化(MDC)和Bland-Altman分析评估重测信度。反应性采用标准化反应均值(SRM)和效应量(ES)进行评估,收敛效度和纵向效度采用与步态、平衡和活动测量相关的Spearman相关。结果:CBWT完成时间在两个方向上都表现出极好的重测信度(ICC = 0.92-0.93; 95% CI = 0.83-0.96)。SEM为30 ~ 31 s, MDC为83 ~ 86 s。四周反应性为中高(SRM = 0.91-1.01; ES = 0.53-0.55)。CBWT完成时间与步态速度(r = -0.70 ~ -0.84)、步行耐力(r = -0.76 ~ -0.81)和行动能力(r = 0.78 ~ 0.83)呈中等至高度相关。甚至在独立活动的参与者中也观察到可变性。结论:本研究结果为亚急性脑卒中患者CBWT的测量特性提供了初步证据。CBWT可以提供结构化环境要求下步行表现的补充临床信息,而不是传统的室内步态评估,这可能支持环境步行适应的评估,并为康复和出院计划期间社区活动能力的临床判断提供信息。
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来源期刊
CiteScore
3.40
自引率
10.00%
发文量
300
期刊介绍: The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.
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