The L test

Original Editor - Yesmine Gouddi Top Contributors - Yesmine Gouddi and Kim Jackson

Definition:

Schematic diagram of the L-test.jpg

The L Test of Functional Mobility (L Test) is a performance-based measure that can be used to assess physical function, including dynamic balance ability.The test is a modification of the Timed Up and Go (TUG) designed to overcome the ceiling effect of the TUG found in higher-functioning patients.[1]

Description:

Participants completed two timed trials of both outcome measurements, with a 1-minute rest between trials and a 2-minute rest between measurements. This was performed on two occasions, seven days apart, to establish test–retest reliability. In order to control medication effects, the trials were completed at approximately the same time of day. Participants completed the TUG and L-test in a randomised order, which was kept consistent between the two occasions. Participants were instructed to walk at their comfortable walking speed, with or without any of their usual walking aids. Prior to participation, the participants received a standardized demonstration and explanation of both outcome measurements. For participant safety, chairs were placed in close proximity to the testing area. In addition, one of the researchers walked in close proximity to the participant without providing any encouragement or trying to set the walking pace. The mean times of both trials were used for data analysis.[2]

Technique:

Equipment:

  • Standard chair without armrests; 1
  • Lines on the floor indicating the 3-meter mark and the 7-meter mark as shown in the Figure;
  • Stopwatch;
  • Assistive device.

Test Set-Up: Have patient sit on the chair with his or her back against the chair, arms resting on the chair’s arms, and if applicable, assistive device at hand.

Patient Instructions[3]: On the word ‘go,’ stand up from the chair, walk to the first line, turn 90 degrees, and walk to the 2nd line, then turn 180 degrees, and return to sit in the chair.

Clinician Instructions : Start the timer on the word “go” and stop the timer when the patient’s buttocks first hits the seat surface when they return. The patient may use an assistive device if needed. Allow 1 practice and then time and record at least 1 trial. The patient walks at their comfortable walking speed.

Scoring:

  1. Objective Scoring = test time taken (generally average score of 3 test trials)
  2. Subjective Scoring = observational information regarding the quality of gait.

Clinical relevence:

The L Test of Functional Mobility (L Test) can be used to assess physical function in patients with a lower-limb amputation who are using a prosthesis[4], in people with Parkinson's[5].

The L-test provides an assessment of walking over a longer walking distance and involves turning in two directions.

References

  1. Kim, J.S., Chu, D.Y., Jeon, H.S. Reliability and validity of the L test in participants with chronic stroke.Physiotherapy. 2015;101:161–165
  2. Death BA, Miller WC. The L test of functional mobility: measurement properties of a modified version of the timed up and go test designed for people with lower-limb amputations. Phys Ther 2005;85(7):626-35
  3. 3Resnik, L., Borgia, M. Reliability of Outcome Measures for People with Lower-Limb Amputations: Distinguishing True Change from Statistical Error. Phys Ther. 2011:91:555-565
  4. Deathe, A.B., Miller, W.C. The L Test of Functional Mobility: Measurement Properties of a Modified Version of the Timed “Up & Go” Test Designed for People with LowerLimb Amputations. Phys Ther. 2005:85:626-635
  5. M Sinha, N Hamdani (PT) Measurement Properties of L Test for Functional Mobility in Stroke Patient International Journal of Scientific Research, Vol : 4, Issue : 7 July 2015