Validation of stroke-specific protocols for the 10-meter walk test and 6-minute walk test conducted using 15-meter and 30-meter walkways

Abstract

Background: Stroke-specific protocols for the 10-meter and 6-minute walk tests that include instructions for people with aphasia, accessible walkway lengths, and allow provision of assistance to walk are needed to facilitate uptake in hospital settings.Objectives: To estimate the test-retest reliability, measurement error, and construct validity of stroke-specific protocols for the 10-meter walk test (10mWT), and 6-minute walk test conducted using a 15-meter walkway (6MWT_15m) and 30-meter walkway (6MWT_30m), in people post-stroke.Methods: A quantitative, cross-sectional study involving ambulatory people post-stroke was conducted.Results: Data were collected from 21 and 20 participants at baseline and retest, respectively, 1-3 days apart. Mean age was 61 years, median time post-stroke was 134 days, and 90% had experienced an ischemic stroke. Performance on the 10mWT, 6MWT_15m, and 6MWT_30m across sessions yielded intraclass correlation coefficient (ICC_{2, 1}) estimates of test-retest reliability of 0.83, 0.97, 0.95, respectively, and minimal detectable change values at the 95% confidence level of 0.40m/s, 44.0m, and 67.5m, respectively. Pearson correlation coefficients were 0.80-0.95 (p < .001) between results on all three walk tests and 0.27-0.48 (p < .25) between walk test results and strength subscale scores on the Stroke Impact Scale.Conclusions: Findings showed excellent test-retest reliability; measurement error values similar to current literature; and support for construct validity of the 10mWT, 6MWT_15m, and 6MWT_30m. Due to the shorter walkway, the 6MWT_15m may be more feasible to implement than the 6MWT_30m in hospital settings. A larger sample with more severe deficits is required to improve generalizability.

Keywords: Stroke; gait speed; measurement error; reliability; validity; walk test; walking capacity.