The shuttle walk test: a new approach to functional walking capacity measurements for patients after stroke?

OBJECTIVE

To determine the construct validity, test-retest reliability, and measurement error of the shuttle walk test (SWT) for patients after stroke.

DESIGN

Clinimetric study.

SETTING

Three rehabilitation centers in the Netherlands.

PARTICIPANTS

A sample of patients after stroke (N=75; mean age ± SD, 58.8±9.8y) who are capable of walking without physical assistance. Patients were excluded if they had sustained a subarachnoid hemorrhage or a stroke in the cerebellum or brainstem, or had any other conditions that limited their walking capacity more than the current stroke, or had sensory aphasia.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Construct validity (6-minute walk test [6MWT]) and test-retest reliability of the SWT were assessed. Measurement error was determined with the standard error of measurement (SEM), limits of agreement, and smallest detectable differences (SDDs).

RESULTS

Construct validity was confirmed by high significant correlations (r(p)≥.65, P<.01) between the SWT and 6MWT. Difference scores were significantly higher in favor of the SWT for high-speed walkers (≥0.8m/s). In the small group (n=12) of low-speed walkers (<0.8m/s), no significant correlations and differences between both tests were found except for walking distance in favor of the 6MWT. Test-retest reliability was good (intraclass correlation coefficient model 2,1 [ICC(2,1)]=.961 [.936-.977]). SEM was 6.0%, and the SDDs for individual and group were 302.0m (37%) and 38.7m (5%), respectively.

CONCLUSIONS

The SWT is a valid and reliable measure and therefore a feasible instrument to determine functional walking capacity of patients after stroke, especially in high-speed walkers.