Assessing the Reliability and Validity of the 4-Meter and the 10-Meter Walk Test to Measure Gait Speed and its Correlation with the Five Sit-to-Stand Test in Chronic Stroke Survivors

Abstract Introduction: Walking speed is an important temporal-distance parameter of gait. The 10-meter walk test is a measure demonstrating excellent reliability and validity but its correlation with the 4-meter walk test in stroke has not been studied. The study aim was to examine the reliability and validity of 4-meter walk test compared to 10-meter walk test as a measure of gait speed in chronic post-stroke. The secondary aim was the evaluate the correlation between both gait measurements and the 5 times sit-to-stand test. Methods: A cross-sectional observational study design was used with comparisons between two different walking tests and 5 times-sit-to-stand. Twenty chronic stroke survivors performed two 10-meter walk test, 4-meter and 5 times sit-to-stand the same day. One investigator performed all measurements. Results: Gait speed measurements shown to have excellent test-retest reliability between 4-meter and 10-meter walk test (ICC=0.906) and there is a strong positive correlation (r=0.867, p<0.001) between both. There is no statistically significant difference in the comparison of the mean of both gait tests (p<0.091), using the paired t-test. However, moderate correlation is found between two gait assessments and 5 times sit-to-stand. Conclusions: This study indicates excellent validity and reliability between 4-meter and 10-meter walk test gait speed measurements in chronic stroke survivors. The use of these two tests for functional evaluation in these individuals is recommended. The 4-meter walk test requires little space, and the health professional does not require any specialist training. Both tests could be used in clinical or home environments during outpatient stroke rehabilitation.

摘要：步行速度是步态（gait）的重要时空参数。10米步行试验（10-meter walk test）是一种具备极佳信度与效度的评估手段，但目前尚无研究探讨其与4米步行试验（4-meter walk test）在脑卒中患者中的相关性。本研究旨在评估慢性卒中后患者中，以4米步行试验作为步态速度测量方式时，相较于10米步行试验的信度与效度。本研究的次要目的为分析两种步行测试与5次坐站试验（5 times sit-to-stand test）的相关性。
方法：本研究采用横断面观察性研究设计，对比分析两种步行测试与5次坐站试验的结果。20名慢性脑卒中患者于同日完成两次10米步行试验、一次4米步行试验及一次5次坐站试验。所有测量操作均由同一名研究者完成。
结果：步态速度测量结果显示，4米与10米步行试验的重测信度极佳（组内相关系数ICC=0.906），且二者间存在强正相关（相关系数r=0.867，p<0.001）。采用配对t检验进行分析后发现，两种步行测试的平均步态速度无统计学显著性差异（p<0.091）。不过，两种步行评估与5次坐站试验之间仅存在中等程度的相关性。
结论：本研究证实，慢性脑卒中患者的4米与10米步行试验步态速度测量结果具备极佳的信度与效度。建议在该类人群的功能评估中应用这两种测试方法。4米步行试验所需空间极小，且医疗专业人员无需接受任何专项培训。两种测试均可应用于门诊脑卒中康复的临床环境或居家场景中。