Reliability and concurrent validity of standardized walking obstacle course test in people with stroke

Abstract

Objectives: To investigate: (i) the intra-rater, inter-rater and test-retest reliabilities of completion times and step counts on the Standardized Walking Obstacle Course test (SWOC); (ii) correlations between SWOC scores and stroke-specific impairments; (iii) the cut-off SWOC completion times and step counts for distinguishing differences in obstacle negotiation ability in people with chronic stroke and healthy older adults. Design: Cross-sectional study. Setting: University-based rehabilitation centre. Subjects: Twenty-nine people with stroke and 30 healthy older adults. Methods: SWOC completion times and step counts were measured under 3 conditions: (i) normal walking; (ii) walking with a tray; and (iii) walking with dark-glasses. The Fugl-Meyer Assessment of lower extremity, the Five-Times-Sit-to-Stand Test, the Berg Balance Scale, the Timed Up and Go Test (TUG), and the Community Integration Measure questionnaire, were also administered. Results: SWOC completion times and step counts showed very satisfactory to excellent reliabilities (intraclass correlation coefficient; ICC = 0.851-0.993). TUG times correlated significantly with SWOC completion times and step counts under the 3 conditions (r = 0.586-0.815, p < 0.001). SWOC completion times of 14.73-16.00 s and step counts of 23.06-24.13, depending on different walking conditions, were able to discriminate between stroke survivors and healthy older adults. Conclusion: The SWOC is a reliable clinical tool for assessing obstacle negotiation ability in people with stroke.