Reliability and discriminative validity of single- and dual-task 10-meter walk test for assessing cognitive-motor interference in children with Duchenne muscular dystrophy.

BACKGROUND

Although cognitive involvement is well documented in Duchenne Muscular Dystrophy (DMD), it is rarely integrated into routine physiotherapy assessments.

PURPOSE: Therefore, this study aimed to examine the test - retest reliability and discriminative validity of the 10-Meter Walk Test (10MWT) under single-task, motor - motor dual-task, and cognitive - motor dual-task conditions in children with DMD.

METHODS

Twenty-three boys with DMD and 12 typically developing (TD) children completed the 10MWT under single-task, motor - motor dual-task, and cognitive - motor dual-task conditions. Walking time under each condition, dual-task costs (DTC), and test-retest reliability were evaluated. Reliability was quantified using intraclass correlation coefficients (ICC(3,1)) based on a two-way mixed-effects model with absolute agreement for single measurements, and discriminative ability was examined using Receiver Operating Characteristic (ROC) curve analysis.

RESULTS

Test-retest reliability ranged from moderate to high across conditions (ICC = 0.583-0.820). All test conditions showed excellent discriminative ability between DMD and TD children (AUC = 1.00 for single-task and motor dual-task; 0.993 for cognitive dual-task; p < 0.001). Children with DMD walked significantly slower than TD children in all conditions (p < 0.001) and exhibited significantly higher DTCs in motor-motor (p = 0.005) and cognitive-motor (p = 0.001) conditions. Within-group analyses demonstrated a significant stepwise deterioration from single-task to dual-task walking in both groups (p < 0.001).

CONCLUSION

The 10MWT under single- and dual-task conditions is a reliable and highly discriminative tool for children with DMD. Beyond measuring motor performance, its dual-task versions allow physiotherapists to indirectly capture cognitive-motor interference, providing clinically meaningful information for more comprehensive functional monitoring and individualized rehabilitation planning in this cognitively affected population.