10 Meter Walk Test

Multiple Sclerosis:

(Paltamaa et al, 2007; n = 120; mean age = 45.0 (10.8) years; mean duration since symptom onset 12.3 (8.8) years, MS)

Predictive Validity:

• Excellent correlation with dependence in self-care (r = 0.60 - 0.87) at comfortable speed
  • Independent vs. perceived difficulties in self-care:
    • OR = 0.72 (0.60 - 0.87) comfortable speed
    • OR = 0.52 (0.37 - 0.73) fastest possible speed
• Adequate to Excellent correlation with dependence in mobility (r = 0.34 - 0.74) at comfortable speed
  • Independent vs. perceived difficulties in mobility
    • OR = 0.50 (0.34 - 0.74) comfortable speed
    • OR = 0.38 (0.21 - 0.67) fastest possible speed
• Adequate to excellent correlation with dependence in domestic life (r = 0.34 - 0.81) at comfortable speed
  • Independent vs. perceived difficulties in domestic life
    • OR = 0.53 (0.34 - 0.81) comfortable speed
    • OR = 0.63 (0.39 - 1.02) fastest possible speed

Children with Neuromuscular Disease:

(Pirpiris, 2003; n = 29; mean age = 11.5 (3.5) years (6-16), Children with Neuromuscular Disease)

• Excellent test-retest reliability (ICC = 0.91)

Geriatrics:

(Parera et al, 2006; n = 100 older adults with mild to moderate mobility limitations in a strength training trial; mean age = 77.6 (7.6) years; two-armed randomized controlled clinical trial of a 3-month home-based strength training intervention; data from baseline and 3-month intervention assessments, Geriatrics)

• SEM = 0.06 m/s

Geriatrics:

(Perera et al, 2006, Geriatrics)

• Small meaningful change = 0.05 m/s
• Substantial meaningful change = 0.13 m/s

Geriatrics:

(Perera et al, 2006, Geriatrics)

• Small meaningful change = 0.05 m/s
• Substantial meaningful change = 0.10 m/s

Parkinson’s Disease:

(Steffen & Seney, 2008; n = 37; mean age = 71; community dwelling adults with Parkinsonism; mean Hoehn & Yahr Stage of 2 (ranged 1 - 4), Parkinson's Disease)

• Comfortable gait speed = 0.18 m/s
• Fastest gait speed = 0.25 m/s

Parkinson’s Disease or Parkinsonism:

(Steffen & Seney, 2008, Parkinson's or Parkinsonism)

• Excellent test-retest reliability for comfortable gait speed (ICC = 0.96)
• Excellent test-retest reliability for maximum gait speed (ICC = 0.97)

SCI:

(Musselman, 2007; n = 19; mean age = 42; > 6 months post motor incomplete SCI, Chronic SCI)

• SEM = 0.05 m/s

See Burns et al, 2011 in MDC data below, Chronic SCI

(van Hedel et al, 2005; n = 22; mean age = 45.5 (16.7) years; method not specified, "measures the time it takes a patient to walk 10m" SEM calculated by Lam et al, 2008, SCI)

• SEM = 0.05 m/s

(Bowden & Behrman, 2007; n = 11; age range = 21 to 68 yrs; mean time post SCI = 24.0 (19.7 months), SCI)

• SEM = 0.76 steps

(Flansbjer et al, 2005; n = 50; mean age = 58 (6.4) years; mean time since stroke onset = 15 (5) months; Swedish sample, Chronic SCI)

• Comfortable gait speed: 0.07 m/s or 7.9% change
• Fastest possible gait speed: 0.08 m/s or 5.7% change

SCI:

(Burns et al, 2011; n = 63; mean age = 43.3 (13.8) years; mean time since injury = 6.32 (5.99) years; Chronic SCI)

(Lam et al, 2008; SCI measures meta analysis, SCI)

• A change of 0.13 m/s was found to detect significant clinical change for the 10MWT

SCI:

(Musselman et al, 2007, SCI)

• MCID = 0.06 m/s

(Lam et al, 2008, SCI)

• Smallest real difference = 0.13 m/s
• Mean change between 1 and 3 months post injury, effect size = 0.92
• Mean change between 3 and 6 months post injury, effect size = 0.47

SCI:

(Lemay & Nadeau, 2010; n = 32; all participants were AIS D; mean age = 47.9 (12.8); mean time post lesion 77.2 (44.3) days, middle 10 m of 15 m timed, Acute SCI)

• Mean (SD) 10MWT (m/s) score; 0.81 (0.34) m/s, range = 0.08 to 1.43
  • Mean (SD) 10MWT for Paraplegia; 0.73 (0.32) m/s, range = 0.08 to 1.35
  • Mean (SD) 10MWT for Tetraplegia; 0.87 (0.34) m/s, range = 0.34 to 1.43

(Olmos et al, 2008; n = 18; all participants were AIS D; time post injury = 6 months; tested three times each with a 60 minute interval between test run, method not specified, "measures the time it takes a patient to walk 10 m", Chronic SCI)

**No statistical difference was observed in gait speed when completing 10MWT in therapy gymnasium vs. community environment (p = 0.663)

SCI:

(Bowden & Behrman, 2007, SCI)

• Excellent test-retest reliability (ICC = 0.97)

(Lam et al, 2008, SCI)

• Excellent test-retest reliability (r = 0.983)

SCI:

(van Hedel et al, 2005, SCI)

• Excellent intrarater reliability (r = 0.983, p < 0.001)
• Excellent interrater reliability (r = 0.974, p < 0.001)
• Bland-Altman plots indicate reliability Excellent when completed in under 40 seconds, but reliability decreases with marginal walkers requiring > 40 seconds to complete

(Scivoletto et al, 2011; n = 37; median age = 58.5 (range 19 - 77) years; median time from onset = 24 (range 6 - 109) months; AIS D = 35, C = 2; Median WISCI = 16, utilized 2 methods, measured 10 m with a static start and measured middle 10 m of 14 m walkway to include acceleration and deceleration, Chronic SCI)

For both methods:

• Excellent interrater reliability (ICC > 0.95)
• Excellent intrarater reliability (ICC > 0.98)

SCI:

(vanHedel et al, 2005; quoted from Lam et al,2008 SCI measures meta analysis, SCI)

Convergent Validity:

• Excellent correlation between the TUG and 10MWT (r  = 0.89, n = 70)
• Excellent correlation between 10MWT and 6MWT (ρ = -0.95, n = 62)
• Subgroup comparisons of WISCI II and 10MWT
  • Excellent correlation between WISCI II and 10MWT when testing individuals with WISCI II scores 11 - 20 (p = -0.68, n = 47)
  • Poor correlation between the WISCI II and 10MWT when testing individuals with WISCI II scores 0 - 10 (r = -0.24, n = 20)
  • Adequate but not significant correlation between WISCI II (0-8,10,11,14,17), dependent walkers (r = -0.35, n = 15)
  • Adequate correlation between WISCI II (9,12,13,15,16,18-20) independent walkers (r = -0.48, n = 43)
• Overall, improved validity in individuals who are less impaired, higher walking ability, and do not require assistance

(Lemay & Nadeau, 2010, Acute SCI)

(Burns et al, 2011; n = 63; mean age = 43.3 (13.8) years; mean time since injury = 6.32 (5.99) years, Chronic SCI)

(van Hedel et al 2006, n = 22, incomplete SCI who could ambulate within the 1^st month post SCI, measured at 1 mo, 3 mo, 6 mo, and 12 mo post, middle 10 m of 14 m walk used, SCI)

(van Hedel et al, 2007; Longitudinal study looking at 6min and 10MWT at 1, 3, and 6 mo post injury, incomplete SCI who were able to ambulate 10m within 3 months post SCI n = 51, 22 tetraplegic, 29 paraplegic; cross sectional study  n = 18 incomplete SCI, acute and chronic range 2 weeks to 8 years AIS C or D, utilized middle 10 m of 14 m walk; Acute; Subacute, SCI)

• Walking speed differed at each time period (1, 3, 6 mo post) but did not differ between the tests
• Regression analysis performed to look at relationship between the tests at preferred and maximum walking speed
  • Preferred walking speed R2 = 0.87
  • Maximum walking speed R2 = 0.86

(van Hedel et al, 2008)

• Excellent correlation of TUG and 10M; however, relationship changes over time.

SCI:

(Jackson et al, 2008; n = 54 expert raters asked to assess each measure in three categories: valid or useful, useful but requires validation or changes/improvements, not useful or valid for research in SCI, SCI)

SCI:

(Lemay & Nadeau, 2010, SCI)

• 10MWT did not demonstrate a ceiling effect and as such allows for further differentiation among subjects with high scores on the BBS (37.5% ceiling effect found in this study)

*Ceiling effect defined as > 20% of subjects reach the maximum score

SCI:

(Lam et al, 2008, SCI)

• Smallest real difference = 0.13 m/s
• Mean change between 1 and 3 months post injury, effect size = 0.92
• Mean change between 3 and 6 months post injury, effect size = 0.47

(van Hedel et al, 2006, SCI)

• 10MWT responsive between 1 - 3 months at P < 0.001
• 10MWT responsive between 3 - 6 months at P = 0.005
  • Effect size greater 1 - 3 months post injury vs. 3 - 6 months post injury;
• 10MWT NOT responsive > 6 months at P = 0.91
  • Small sample size who reached normal walking speeds (1.39 m/s) at 6 months
  • Statistically significant correlation between 10MWT and 6MWT remained at 12 months post injury (< 0.001)
• The 10MWT was found to be more responsive in detecting locomotor improvement than the WISCI II in individuals who achieved greater overall walking ability (WISCI II scores ≥ 20) at 6 months post injury (AIS D)

Stroke:

(Perera et al, 2006; n = 100 subacute stroke survivors in an interventional trial; mean age = 69.8 (10.3) years; two-arm randomized trial of a 3-month program of therapeutic exercise in stroke survivors, Stroke)

• SEM = 0.04 m/s

Stroke:

(Perera et al, 2006, Stroke)

• Small meaningful change = 0.06 m/s

• Substantial meaningful change = 0.14 m/s 

(Tilson, 2010; n = 283; mean age = 63.5 (12.5) years; assessed at approximately day 20 and day 60 post stroke, 14m walk with middle 10 m timed with or without assistance, Acute Stroke)

• MCID = 0.16 m/s

Stroke:

Ambulation ability has been correlated with gait speed (Perry et al, 1995); changes in gait speed that result in a transition to a higher category of ambulation classification resulted in better function and quality of life (Schmid et al, 2007); ambulation ability that is predicted by gait speed is a reliable method of classifying patients (Bowden et al, 2008)

• < 0.4 m/s were more likely to be household ambulators
• 0.4 - 0.8 m/s limited community ambulators
• > 0.8 m/s were community ambulators

Stroke:

(Severinsen et al, 2011, n = 48, participants aged 68 (9) years, with reduced muscle strength and walking capacity due to an ischemic stroke 18 (6) prior to recruitment, performed 3 times, using the mean value in further analyses, Stroke)

• Mean (± SD) 10MWT (m/s) score; for Stroke 0.84 ± 0.3 m/s
• Normalized Test Values % (95% CI); 59 (52–66)%

Stroke:

(Collen, 1990; n = 25; mean age = 72 years; stroke onset = 2 to 6 years, Chronic Stroke)

Test-retest assessed three times within a single session:

• Excellent test-retest reliability (ICC = 0.95 to 0.99)

(Flansbjer et al, 2005, Chronic Stroke)

• Excellent reliability for comfortable (ICC = 0.94) and fast (ICC = 0.97) gait speeds

Stroke:

(Collen et al, 1990, Stroke)

• Excellent intrarater reliability; ICC = 0.87 to 0.88

(Wolf et al, 1999; n = 28 with history of stroke; mean age = 56.04 (12.80) years; mean time since lesion = 13.59 (12.30) months, Chronic Stroke)

• Excellent interrater reliability; (ICC = 0.998)

Stroke:

(Tyson & Connell, 2009; n = 40, review article of 17 measures, Stroke)

Predictive Validity:

• Excellent correlation with dependence in instrumental activities of daily living (r = 0.76)
• Excellent correlation with Barthel Index (r = 0.78)

Stroke:

(Lin et al, 2010; n = 45; time post stroke = >1 year, Stroke)

(Wolf et al, 1999, Stroke)

• Excellent correlation with BBS (r = 0.627)
• Adequate correlation with FRT (r = 0.349)

(Flansbjer et al, 2005, Chronic Stroke)

• Excellent correlation between comfortable gait speed and TUG (ICC = -0.84), FGS (ICC = 0.92), Stair climbing ascend (SCas) (ICC = -0.81), Stair climbing descend (SCde) (ICC = -0.82), 6MWT (ICC = 0.89)
• Excellent correlation between fast gait speed and TUG (ICC = -0.91), CGS (ICC = 0.88), SCas (ICC = -0.84), SCde (ICC = -0.87) and 6MWT (ICC = 0.95)

Stroke:

(Perera et al, 2006, Stroke)

• Small meaningful change = 0.05 m/s
• Substantial meaningful change = 0.10 m/s

TBI:

(Watson et al, 2002, n = 10 patients with TBI who were walking independently with or without walking aids; n = 28 healthy adults (no demographic information given; TBI)

• Change in performance of > 0.05 seconds is greater than rater error (TBI)

TBI:

(vanLoo and Moseley, 2004; n = 13; mean age = 32.5 (11.3) years; average time post injury 11.9 (15.7) months; mean initial GCS 5.8 (2.9); mean PTA 43.8 (39.1) days, walked 14 meters with middle 10 timed, TBI)

• Change is reflected by 0.15 and 0.25 m/s increase in comfortable and fast-paced walking speed respectively

(Watson et al, 2002, TBI)

• Change in performance of > 0.05 is attributed to "real variation in severe TBI subjects

TBI:

(vanLoo et al, 2004, TBI)

• Excellent between day reliability at comfortable (ICC = 0.95) and fast speeds (ICC = 0.96)

(Watson et al, 2002, TBI)

• Excellent test-retest reliability (r = 0.97 - 0.99)

TBI:

(Tyson & Connell, 2009; review of seventeen measures; n = 12 mobile TBI patients, TBI)

• Excellent interrater reliability (ICC = 0.99)

TBI:

(Moseley et al, 2004, n = 10, mean age 31.9 (14.2) years, mean days post injury = 56.4 (25.5); mean duration of PTA = 26.6 (8.7) days, 14 m walk with central 10 m timed, TBI)

• Poor correlation between 10 meter walk test in clinic compared to natural environments including: parking lot in shopping center (ICC = -0.024), Inside a shopping center (ICC = -0.14), corridor in a brain injury unit (ICC = 0.21)
• Walking speed is faster when measured under clinical conditions in individuals with TBI

Hip Fracture:

(Hollman et al, 2008, n = 16, participants aged 77.9 (9.0) years, tested at a mean of 4.7 (2.0) days, range = 2 to 8 days, after surgical fixation of their hip fractures, after rest a second trial under the same parameters was conducted, Hip Fracture)

• SEM = 0.03 m/s

Hip Fracture: 

(Latham et al, 2008; aged > 65 years; within 17 days of surgical repair of hip fracture; sample included Norway, United Kingdom, Sweden, Israel, Germany, United States, Denmark, Spain; gait speed tested over 4 meters of walking after 12 weeks, Hip Fracture)

• Gait speed MDC = 0.17 m/s

(Hollman et al, 2008, Hip Fracture)

• MDC at 95% confidence level = 0.82 m/s

Hip Fracture:

(Hollman et al, 2008, Hip Fracture)

• Trial 1: Mean (± SD) 10MWT (m/s) score; for Hip Fracture 0.15 ± 0.05 m/s, (range = 0.08 to 0.24 m/s)
• Trial 2: Mean (± SD) 10MWT (m/s) score; for Hip Fracture 0.16 ± 0.07 m/s, (range = 0.07 to 0.36 m/s)
  • The Bland-Altman plot indicates that no systemic bias between the first and second trials occurred
  • Mean difference in gait velocity between trial 1 and trial 2 was 0.013 m/s, with limits of agreement between -0.057 and 0.083 m/s

Hip Fracture:

(Hollman et al, 2008, Hip Fracture)

• Excellent test-retest reliability (ICC = 0.823 with 95% CI = 0.565 to 0.934)

Hip Fracture:

(Latham et al, 2008, Hip Fracture)

• Excellent correlation with 6MWT (correlation coefficient = 0.82)
• Adequate correlation with LE strength (r = 0.51)
• Adequate correlation with LE power (r = 0.58)
• Poor correlation with hip pain (r = -0.23)
• Poor correlation with bodily pain (r = 0.30)
• Poor correlation with vitality (r = 0.26)
• Adequate correlation with physical role (r = 0.54)
• Adequate correlation with social role (r = 0.42)

Healthy adults: (Bohannon 1997; n=230 healthy volunteers)

Healthy Adults (Bohannon RW & Andrews AW, 2011; n=23,111)