The six‐spot‐step test – a new method for monitoring walking ability in patients with chronic inflammatory polyneuropathy

Abstract

The aim of this study was to evaluate whether the six-spot-step test (SSST) is more suitable for monitoring walking ability in patients with chronic inflammatory polyneuropathy than the timed 25-foot-walking test (T25FW). In the SSST, participants have to walk as quickly as possible across a field measuring 1 × 5 m, while kicking blocks out of five circles on the floor. Sixty-two patients and 61 controls performed the SSST and T25FW. Patients also performed the overall disability sumscore, INCAT sensory sumscore, Medical Research Council sumscore, and 9-hole-peg-test. Twenty-one patients treated with intravenous immunoglobulin (IVIG) every 4-6 weeks were tested prior to and 2-3 weeks after treatment and judged change in their own clinical condition using the patient global impression of change (PGIC) scale. In patients, SSST ranged from 5.7 to 26.8 s and T25FW ranged from 3.6 to 12.9 s. Intra-class correlation between repeated tests was 0.97 for SSST and 0.95 for T25FW. Correlation with the additional tests was stronger for SSST than T25FW. In IVIG-treated patients, the mean change in walking time was -2.3 s for SSST and -0.6 s for T25FW. The SSST showed larger responsiveness in terms of effect size, standardized response means, and relative efficiency. Both ambulation tests correlated moderately to PGIC. The SSST may be superior to the T25FW in terms of dynamic range, floor effect, and responsiveness which makes the SSST a possible alternative for monitoring walking ability in patients with chronic inflammatory polyneuropathy.

A population‐based and cross‐sectional study of the long‐term prognosis in multifocal motor neuropathy

“…For evaluation of combined weakness and ataxia, a six spot step test (SSST) in which five blocks are kicked away during walking was applied …”

“…For evaluation of combined weakness and ataxia, a six spot step test (SSST) in which five blocks are kicked away during walking was applied. 16,17 For mood, social performance, self-rated quality of life, and severity of fatigue, we used the major depression inventory (MDI), 18 the 24-item social adjustment scale-self report: short (SAS-SR), 19 the EQ-5D-5 L-VAS 14,15 and the Fatigue Severity Scale (FSS) 20 as described elsewhere.…”

A population‐based study of long‐term outcome in treated chronic inflammatory demyelinating polyneuropathy

“…For evaluation of walking a Timed 25‐Foot Walk (T25FW) and for dexterity a Nine‐Hole Peg Test (9‐HPT) were applied. For evaluation of combined weakness and ataxia, a Six Spot Step Test (SSST) in which five blocks are kicked away during walking was included …”

“…For evaluation of combined weakness and ataxia, a Six Spot Step Test (SSST) in which five blocks are kicked away during walking was included. 21,22 Aerobic capacity was measured during a 6-minute submaximal exercise test using a cycle ergometer. 23 The obtained heart rate at the given effect was transformed to aerobic capacity using an Åstrand-Ryhming nomogram, including a previously published formula with age correction obtained at regression analysis.…”

Quality of life in chronic inflammatory demyelinating polyneuropathy patients treated with subcutaneous immunoglobulin

“…14 Walking performance was assessed with a 40-meter-walk test (40-MWT) and the 6-spot-step test (6-SST). 15,16 Bonferroni correction was performed to adjust for multiple comparisons with a P-value < .002 (0.05/25 comparisons).…”