Outcome Measures for Gait and Ambulation in the Spinal Cord Injury Population

Abstract

FIM-L).Methods: A subcommittee of international experts evaluated each instrument for test construct, administration, population applicability, reliability, sensitivity to change, and validity. Evaluations for each outcome measure were compiled, distributed to the whole committee, and then further reviewed with addition of comments and recommendations for consensus. An audience of experts voted on the validity and usefulness of each measure. Results: WISCI II and 10MWT were found to be the most valid and clinically useful tests to measure improvement in gait for patients with SCI. FIM-L had little utility and validity for research in SCI. 6MWT and 50FTWT were found to be useful but in need of further validation or changes for the SCI population. Conclusion: A combination of the 10MWT and WISCI II would provide the most valid measure of improvement in gait and ambulation in as much as objective changes of speed, and functional capacity allow for interval measurement. To provide the most comprehensive battery, however, it will be important to include a measure of endurance such as the 6MWT. Further validation and study should be devoted to WISCI II, 10MWT, and 6MWT as primary outcome measures for gait in SCI.

Reliability and validity of three functional tests in ambulatory patients with spinal cord injury

“…The 10MWT reflects walking speed that associates with motor function, walking endurance and overall quality of gait. 10 The TUGT requires subjects to perform sequential locomotor tasks that incorporate sitting-to-standing, walking and turning activities. Results of the test correlate with levels of functional mobility, balance and postural control, walking ability and the risk of falls.…”

“…Subjects with FIM-L 6 were those who could walk independently at least 50 m with the use of a walking device, and FIM-L 7 referred to those who were able to walk independently at least 50 m without using any assistive devices. 10 On the second day, subjects were tested for their functional abilities using the 10MWT, TUGT and FTSST in a random order using the Latin square to minimize carrying-over effects due to sequences of the tests that might occur such as fatigue and learning effects. Each test was performed over three trials, and the average performance of the three trials was used for data analysis.…”

“…10 The timed up and go test (TUGT) measures balance control during upright and walking activities. 11 The five times sit-to-stand test (FTSST) correlates with LEMS, multiple sensorimotor processes, balance control and psychological status.…”

“…15 This may suggest the use of criteria from other disability scales to classify levels of independence of patients with SCI such as the Functional Independent Measurement Locomotor (FIM-L) scores, which by definition measure levels of functioning of patients in different environments that accurately reflect burden of care. 10,19 Thus this study evaluated the reliability and validity (in terms of discriminative ability and concurrent validity) of the 10MWT, TUGT and FTSST using the FIM-L scores as a standard criterion. Findings of the study would direct the use of these tests to quantify and monitor the levels of independence of the patients.…”

Impact of a 10-Week Individualized Exercise Program on Physical Function and Fatigue of People with Multiple Sclerosis

“…Time is recorded when the person completely crosses over the end tape. 28 This test has been found to be valid and reliable in measuring mobility and gait speed of patients with neurologic impairment 29 and reliable (ICC = 0.97) when testing individuals with MS. 24 …”