Authors (including presenting author) :
Chao YLC (1), Fong WC (2), Yeung CSS (1), Wan PCS (1), Wong HSG (1), Yu CWG (1), Chan CMA (1)
Affiliation :
(1) Physiotherapy Department, Queen Elizabeth Hospital (2) Department of Medicine, Queen Elizabeth Hospital
Introduction :
Motor and balance impairment is a major challenges faced by many stroke survivors and it causes difficulties in gait performance for performing daily activities and a high risk of falls. Improving gait ability together with accurate assessment and monitoring with respect to safety and quality is a major goal for rehabilitation after stroke. Currently, majority of the clinical measures of gait assessment consist of straight-path walking only and yet most of the activities of daily living and fall incidents happened in curved-path walking. The Figure-of-8 Walk Test (F8WT) involves straight and curved paths in both clockwise and counterclockwise directions which can mimic the movement of daily life and minimize the lateralization effects of different lesion sides of the brain after stroke.
Objectives :
To determine (i) the inter-rater, intra-rater and test-retest reliability of F8WT, (2) and the correlation between F8WT with motor and balance functions in people with hemiparesis after stroke.
Methodology :
Twenty-five chronic stroke patients, aged 57.8 ± 1.2 years old, who presented with hemiparesis and able to walk with or without aids for at least 10m independently was recruited to participate in the study. All participants were instructed to walk at their usual pace in a figure-of-8 path around the 2 cones placed 1.52 meter (5 feet) apart. The total time and number of steps taken to complete the course were recorded. Faster time and fewer steps indicate better curved-path walking ability. Two trials of walking test were performed in 2 separate days at 1-week time intervals by 2 experienced physiotherapists. The 2 trials administered by the same and different assessors within the same visit were used to determine intrarater and interrater reliability respectively. The trials of the initial and second visits conducted by the same assessor were used to calculate the test-retest reliability. In addition, muscle strength of knee extensor, 10-meter Walk Test (10MWT), Berg Balance Scale (BBS) and Timed Up and Go Test (TUGT) were also evaluated by one assessor on the first visit. The orders of testing were randomized. A 2-minute rest was given to the participants between different outcome measurements in order to eliminate the effect of fatigue.
Result & Outcome :
Excellent intra-rater, inter-rater and test-retest reliabilities (intra-class correlation coefficient (ICC) range 0.918-0.990) of both the time and steps component of the F8WT were found. The F8WT steps were also found to be significantly negatively correlated with knee extensor strength of affected side (r=-0.474, p=0.017) and BBS (r=-0.708, p<0.001) and positively correlated with 10MWT (r=0.489, p=0.013), TUGT in affected side turning (r=0.478, p=0.016) and unaffected side turning (r=0.490, p=0.013). The F8WT is a simple, reliable, and easily administered clinical tool for assessing the motor and walking performance of hemiparesis patients after chronic stroke. The F8WT steps also correlated well with stroke-specific impairments, balance performance and other walking tests.
