10 Metre Walk Test

Objective
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The 10 Metre Walk Test is a performance measure used to assess walking speed in metres per second over a short distance. It can be employed to determine functional mobility, gait and vestibular function.

Intended Population
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Preschool children (2-5 years), children (6-12 years), adolescents (13-17 years), adults (18-64 years), alderly adults (65+) with a range of diagnoses including: 

  • Acquired Brain Injury
  • Geriatrics
  • Hip Fracture
  • Lower Limb Amputation
  • Movement Disorders
  • Multiple Sclerosis
  • Parkinson’s Disease
  • Spinal Cord Injury
  • Stroke
  • Traumatic Brain Injury

Method of Use[edit | edit source]

Equipment Required

  • Stopwatch
  • A clear pathway with set distance (6, 8, 10 metres in length depending on distance tested)

Set Up

Measure and mark a 10-metre walkway

  • Add a mark at 2-metres
  • Add a mark at 8-metres

Instructions

  • The individual walks without assistance for 10 metres, with the time measured for the intermediate 6 metres to allow for acceleration and deceleration
  • Assistive devices may be used, but must be kept consistent and documented for each test
  • Start timing when the toes pass the 2 metre mark
  • Stop timing when the toes pass the 8 metre mark
  • Can be tested at either preferred walking speed or maximum walking speed (ensure to document which was tested)
  • Perform three trials and calculate the average of three trials

Patient Instructions

  • Normal comfortable speed: “I will say ready, set, go. When I say go, walk at your normal comfortable speed until I say stop”
  • Maximum speed trials: “I will say ready, set, go. When I say go, walk as fast as you safely can until I say stop”


Interpretation of results[edit | edit source]

Evidence[edit | edit source]

Reliability[edit | edit source]

The 10 metre walk test has demonstrated excellent reliability in many conditions including health adults, children with neuromuscular disease, Parkinsons, hip fracture, SCI, Strike and TBI: 

Test-Retest Reliability

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

  • Excellent test-retest reliability (ICC = 0.91) [1]

Healthy Adults:

  • Excellent test-retest reliability for comfortable gait speed (r = 0.75 - 0.90) [2]
  • Excellent test-retest reliability for comfortable and fastest gait speeds (ICC = 0.93 - 0.91) [3]

Hip Fracture:

  • Excellent test-retest reliability (ICC = 0.823 with 95% CI = 0.565 to 0.934) [4]

Parkinson’s Disease or Parkinsonism:

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

SCI:

  • [6]Excellent test-retest reliability (ICC = 0.97)
  • [7]Excellent test-retest reliability (r = 0.983)

Stroke:
(n = 25; mean age = 72 years; stroke onset = 2 to 6 years, Chronic Stroke)
Test-retest assessed three times within a single session:

  • [8] Excellent test-retest reliability (ICC = 0.95 to 0.99)
  • [9] Excellent reliability for comfortable (ICC = 0.94) and fast (ICC = 0.97) gait speeds 

TBI:

  • [10] Excellent between day reliability at comfortable (ICC = 0.95) and fast speeds (ICC = 0.96)
  • [2] Excellent test-retest reliability (r = 0.97 - 0.99)

Interrater/Intrarater Reliability

Healthy Adults:

(n = 28 healthy adults; mean age = 56.43 (13.82) years; Healthy Adults)

  • Excellent interrater reliability; (ICC = 0.980) [11]

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 [12]

(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) [13]

Stroke:

  • Excellent intrarater reliability; ICC = 0.87 to 0.88 [8]

(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) [11]

TBI:

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

  • Excellent interrater reliability (ICC = 0.99) [14]

Validity[edit | edit source]

Criterion Validity

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 [15]:

  • Excellent correlation with dependence in self-care (r = 0.60 - 0.87) at comfortable speed
  • Adequate to Excellent correlation with dependence in mobility (r = 0.34 - 0.74) at comfortable speed
  • Adequate to excellent correlation with dependence in domestic life (r = 0.34 - 0.81) at comfortable speed

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

Predictive Validity [14]:

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

Construct Validity

Healthy Adults:

  • Poor correlation with BBT (r = 0.052)
  • Adequate correlation with FRT (r = 0.307) [11]

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) [16]

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 [17]

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) [9]

Responsiveness[edit | edit source]

Geriatrics:

  • Small meaningful change = 0.05 m/s
  • Substantial meaningful change = 0.10 m/s [18]

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 [7]

Stroke:

  • Small meaningful change = 0.05 m/s
  • Substantial meaningful change = 0.10 m/s [18]

Miscellaneous
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Links[edit | edit source]

10-Metre Walk Test

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References[edit | edit source]

  1. Pirpiris, M., Wilkinson, A., et al. "Walking speed in children and young adults with neuromuscular disease: comparison between two assessment methods." Journal of Pediatric Orthopaedics 2003 23(3): 302
  2. 2.0 2.1 Watson, M. J. "Refining the ten-metre walking test for use with neurologically impaired people." Physiotherapy 2002 88(7): 386-397
  3. Bohannon, R. W. "Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants." Age Ageing 1997 26(1): 15-19
  4. Hollman, J. H., Beckman, B. A., et al. "Minimum detectable change in gait velocity during acute rehabilitation following hip fracture." J Geriatr Phys There 2008 31(2): 53-56
  5. Steffen, T. and Seney, M. "Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism." Physical Therapy 2008 88(6): 733-746
  6. Bowden, M. G. and Behrman, A. L. "Step Activity Monitor: accuracy and test-retest reliability in persons with incomplete spinal cord injury." J Rehabil Res Dev 2007 44(3): 355-362
  7. 7.0 7.1 Lam, T., Noonan, V., et al. "A systematic review of functional ambulation outcome measures in spinal cord injury." Spinal Cord 2007 46(4): 246-254
  8. 8.0 8.1 Collen, F., Wade, D., et al. "Mobility after stroke: reliability of measures of impairment and disability." Disability &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Rehabilitation 1990 12(1): 6-9 Cite error: Invalid <ref> tag; name "Collen et al" defined multiple times with different content
  9. 9.0 9.1 Flansbjer, U. B., Holmback, A. M., et al. "Reliability of gait performance tests in men and women with hemiparesis after stroke." J Rehabil Med 2005 37(2): 75-82
  10. van Loo, M. A., Moseley, A. M., et al. "Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study." Brain Inj 2004 18(10): 1041-1048
  11. 11.0 11.1 11.2 Wolf, S. L., Catlin, P. A., et al. "Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile." Phys There 1999 79(12): 1122-1133 Cite error: Invalid <ref> tag; name "Wolf et al" defined multiple times with different content Cite error: Invalid <ref> tag; name "Wolf et al" defined multiple times with different content
  12. van Hedel, H. J., Wirz, M., et al. "Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests." Archives of Physical Medicine and Rehabilitation 2005 86(2): 190-196
  13. Scivoletto, G., Tamburella, F., et al. "Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients." Spinal Cord 2011 49(6): 736-740.
  14. 14.0 14.1 Tyson, S. and Connell, L. "The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: a systematic review." Clin Rehabil 2009 23(11): 1018-1033
  15. Paltamaa, J., Sarasoja, T., et al. "Measures of physical functioning predict self-reported performance in self-care, mobility, and domestic life in ambulatory persons with multiple sclerosis." Archives of physical medicine and rehabilitation 2007 88(12): 1649-1657
  16. Latham, N., Mehta, V., et al. "Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients?" Archives of physical medicine and rehabilitation 2008 89(11): 2146-2155
  17. van Hedel, H. J., Wirz, M., et al. "Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests." Archives of Physical Medicine and Rehabilitation 2005 86(2): 190-196
  18. 18.0 18.1 Perera, S., Mody, S., et al. "Meaningful change and responsiveness in common physical performance measures in older adults." Journal of the American Geriatrics Society 2006 54(5): 743-749