Comparison of Speeds Used for the 15.2-Meter and 6-Minute Walks Over the Year After an Incomplete Spinal Cord Injury: The SCILT Trial

Abstract

Background. Timed walking speed for 6 to 15 m and the distance walked in 2 to 12 minutes are frequently used outcome measures in rehabilitation trials, presumably reflecting different aspects of walking ability. The database from the Spinal Cord Injury Locomotor Trial (SCILT), which tested 2 interventions for mobility upon admission for initial rehabilitation of an incomplete traumatic spinal cord injury (SCI), was used to compare the walking speed employed for each test. Methods. From 66 to 70 patients with upper motor neuron lesions from C-5 to T-10 performed a 15.2-m and a 6-minute walk as fast as the patient deemed safe at 3 months (end of the trial intervention) and 6 and 12 months after entry. The means, standard errors, and quartiles were calculated for the speed used for each task. Results. The mean speed for the 15.2-m walk did not differ from that used for the 6-minute walk at 3 and 6 months but was significantly faster at 12 months. Differences became apparent at each assessment in patients in the highest quartiles (>1.0 m/s) for the 15.2-m walk. Their speed was from 14% to 24% higher than the speed used for the 6-minute walk. Conclusion. The speed of the 15.2-m walk as a measure of walking ability compared to the distance walked in 6 minutes may not represent separable domains of mobility. Differences were apparent only in the most highly functional patients, who could ambulate in the community. Any difference in the walk-

Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients

“…In the present study, it is difficult to decide whether the difference in the distance walked is because of a different shape (as the short track required the patients to turn 1801 and the long one to 901 turns), the frequency of turns or both factors. Although the report of the conference on outcome measures 21 recommended further work on the 6MWT, which stimulated our study, recent publications 6,15 suggest that short distance speed of walking is adequate for a clinical trial. In light of our findings and the need to consider longer distances in chronic subjects and follow-up longer than 6 months, standardization may result in sharper responsiveness to change.…”

“…3 Therefore, the recovery of ambulation has become the target of several pharmacological and rehabilitative approaches 4 and a precise evaluation of ambulation in these patients has become mandatory. Although several walking measures have been suggested for assessment of walking function in patients with SCI, over the past 5 years most studies have focused on the 10-m walk test (10MWT), 5-14 the 6-min walk test (6MWT) [5][6][7][8][9][10]13,15 and the Walking Index for Spinal Cord Injury (WIS-CI). 5,7,9,12,14,[16][17][18][19][20] This set of measures allows a comprehensive assessment of walking function, which includes the use of walking aids, braces, physical assistance, and speed and endurance.…”

“…Both the 10MWT and the 6MWT have been utilized in studies of SCI patients. [5][6][7][8][9][10][11][12][13][14][15][16] Both tests showed good inter-and intra-rater reliabilities, 5 a good relationship with lower limbs strength 17 and with other walking tests (the WISCI and the 'timed up and go'). 5 Furthermore, both tests seem to have a greater sensitivity to detect changes of performance in less severely injured SCI patients if compared with the WISCI, which has a ceiling effect.…”

“…Several other studies in SCI by the same authors did not identify either the shape of the track or the frequency of turns. 5,7,8,15 Therefore, we propose to test the following hypotheses: 10MWT…”

Walking capacity evaluated by the 6‐minute walk test in spinal and bulbar muscular atrophy

“…29 It has also been employed to assess functional exercise capacity in neuromuscular diseases such as stroke, Parkinson's disease, cerebral palsy, chronic poliomyelitis, multiple sclerosis, myotonic dystrophy, fibromyalgia, and spinal cord injury. 2,7,8,11,12,16,21,23,25,27 In diseases that affect multiple regions of the nervous system, the 6 min walk distance (6MWD) correlates well with other measurements that evaluate systemic motor function such as muscle strength, clinical scores, and health status questionnaires. 16,23,25 The aim of this study was to evaluate functional exercise capacity in patients with SBMA using the 6MWT.…”