Program

CO56-004

Oral Communication

Locomotor independence level assessment of stroke survivors using an obstacle course : development and validation.

Mr Gilles ARENOa, Mr Xavier MASSONa, Dr Florent MOISSENETb

a Groupe SEF, CNRFR – Rehazenter, b Laboratoire d’Analyse du Mouvement et de la Posture, CNRFR – Rehazenter

Objective: Traditional gait assessments often evaluate patients in idealised conditions (level ground, straight way, no obstacle) in order to define the gait capacity. In this sense, the way the patient walks in daily gait conditions remains unknown and the level of locomotor independence cannot be evaluated. The aim of this study was thus to develop and validate a course with ecological gait conditions. This tool must be able to categorise patients by their capacity to cross a set of obstacles linked to three level of independence: limited household walkers, limited community walkers and community walkers [1].

Material/Patients: The gait obstacle course is composed of four 10-m walking tests (t1 to t4) and one 6-min walking test. The tests t1 and {t2, t3, t4} respectively represent the traditional 10-m walk test and a set of 10-m walk tests with obstacles corresponding to the 3 evaluated levels of independence. 14 stroke survivors patients (50 +/- 15 years old) were selected and gave their consent. This study was validated by the local ethic committee of CNRFR - Rehazenter.

Method: The time to perform each part of the course was evaluated for all the patients 3 times by 2 operators in a randomised order. In order to realise a first validation of the course, inter- and intra-operator tests were then performed based on these records. A Wilcoxon test was employed for that with a confidence level of 95%.

Results: On the whole, patients having a similar functional level present difficulties at the same part of the gait obstacle course. Moreover, tests {t2, t3, t4} and {t1, t2, t4, 6min} present a significant reproducibility inter- and intra-operator.

Discussion: Results are encouraging and demonstrate the potential of the proposed gait obstacle course. However, this first validation must be completed by evaluating much more patients and by achieving additional tests such as sensitivity tests before a daily clinical use.

References

[1] J. Perry and J. Burnfield, Gait Analysis: Normal and Pathological Function, 2012 ; Slack, New York

Keywords : Gait course, independance level, ecological conditions, stroke.