Ten-meter ambulation test in spastic paresis
Dr Emilie HUTINa, Mrs Mouna GHÉDIRAa, Dr Catherine-Marie LOCHEa, Dr Valentina MARDALEa, Prof Jean-Michel GRACIESa
a Laboratoire Analyse et Restauration du Mouvement, EA BIOTN, Hôpitaux Universitaires Henri Mondor, Assistance Publique - Hôpitaux de Paris, Université Paris-Est Créteil (UPEC), France
The function of lower limb in spastic paresis could be evaluated with ambulation test including sit-to-stand, stand-to-sit, turns and straight walk over sufficient distance. We proposed 10-meter ambulation test (AT10) from seated to seated position. The present study aimed to measure intra- and inter-reliability of the AT10 in chronic hemiparesis.
Ten subjects with chronic hemiparesis (45±12y, time since stroke 16±9 months, mean±standard deviation) performed four AT10: with shoes and barefoot, at a 'natural' pace and then at 'maximal' speed on two occasions one week apart (test and re-test). The total number of steps - including during turns - and time to complete the task were clinically measured by 4 independent raters. Speed (SP), step length (SL) and cadence (CAD) were derived. Inter- and intra-rater reliability were assessed using intraclass correlation coefficient (ICC), the agreement frequency procedure, agreements being defined as a speed difference <0.05 m/s, a step length difference <0.05 m and a cadence difference <0.1 step/s.
For all conditions, mean intra-rater ICC were >95% (SP, 98.5±0.1%; SL, 98.3±0.1%; CAD, 96.5±0.1%) and agreement frequency >68% (SP, 76±8%; SL, 90±9%; CAD, 77±6%). Mean intra-rater difference was 0.05±0.01 m/s in speed, 0.02±0.01 m in step length and 0.08±0.01 step/s in cadence. Mean inter-rater ICC were >98% (SP, 99,9±0,1%; SL, 99,7±0,2%; CAD, 98,9±0,5%) and agreement frequency ≥90% (SP, 95±3%; SL, 99.6±0.8%; CAD, 94±4%). Mean intra-rater difference was 0.01±0.003 m/s in speed, 0.006±0.002 m in step length and 0.04±0.005 step/s in cadence.
The AT10 intra- and inter-rater reliability was excellent in chronic hemiparesis. The discrepancy between outstanding ICC and fewer raw agreements for the intra-rater measurements owed to the fact that subjects improved between the two tests.
Keywords : Hemiparesis, Ambulation test, Speed, Step length, Cadence.