Measurement of community ambulation after stroke: current status and future developments

Abstract

Background and purpose: This report considers the measurement of community ambulation for people with stroke. The conceptual issues underlying measurement of community ambulation are reviewed, and tests that measure either the task itself or at least some of its components are identified and discussed.

Conclusions: The findings from this review suggest that although some progress has been made toward identifying community ambulation as a stand-alone entity, reliable and valid measures have not yet been developed. Gait speed, which is used often as a proxy measure for community ambulation, does not consistently reflect the level of community ambulation attained, and continued reliance on its use, particularly the 10-m timed walk, is misplaced. The limitations of the measures reviewed here point toward self-report as being the most useful outcome for current clinical use. However, this report highlights the need for research to first inform a theoretical framework for the measurement of community ambulation, from which a measurement tool or a battery of measurements can be developed and tested.