10 Metre Walk Test

The 10 Metre Walk Test is a performance measure used to assess walking speed in metres per second over a short distance. It can be employed to determine functional mobility, gait and vestibular function.

Intended Population

Preschool children (2-5 years), children (6-12 years), adolescents (13-17 years), adults (18-64 years), alderly adults (65+) with a range of diagnoses including: 

• Acquired Brain Injury
• Geriatrics
• Hip Fracture
• Lower Limb Amputation
• Movement Disorders
• Multiple Sclerosis
• Parkinson’s Disease
• Spinal Cord Injury
• Stroke
• Traumatic Brain Injury

Method of Use

Equipment Required

• Stopwatch
• A clear pathway with set distance (6, 8, 10 metres in length depending on distance tested)

Set Up

Measure and mark a 10-metre walkway

• Add a mark at 2-metres
• Add a mark at 8-metres

Instructions

• The individual walks without assistance for 10 metres, with the time measured for the intermediate 6 metres to allow for acceleration and deceleration
• Assistive devices may be used, but must be kept consistent and documented for each test
• Start timing when the toes pass the 2 metre mark
• Stop timing when the toes pass the 8 metre mark
• Can be tested at either preferred walking speed or maximum walking speed (ensure to document which was tested)
• Perform three trials and calculate the average of three trials

Patient Instructions

• Normal comfortable speed: “I will say ready, set, go. When I say go, walk at your normal comfortable speed until I say stop”
• Maximum speed trials: “I will say ready, set, go. When I say go, walk as fast as you safely can until I say stop”

Reliability

The 10 metre walk test has demonstrated excellent reliability in many conditions including health adults, children with neuromuscular disease, Parkinsons, hip fracture, SCI, Strike and TBI: 

Test-Retest Reliability

Children with Neuromuscular Disease:
(n = 29; mean age = 11.5 (3.5) years (6-16), Children with Neuromuscular Disease)

• Excellent test-retest reliability (ICC = 0.91)

Healthy Adults:

• Excellent test-retest reliability for comfortable gait speed (r = 0.75 - 0.90) 

• Excellent test-retest reliability for comfortable and fastest gait speeds (ICC = 0.93 - 0.91)

Hip Fracture:

• Excellent test-retest reliability (ICC = 0.823 with 95% CI = 0.565 to 0.934) 

Parkinson ’s disease or Parkinsonism:

• Excellent test-retest reliability for comfortable gait speed (ICC = 0.96)
• Excellent test-retest reliability for maximum gait speed (ICC = 0.97)

SCI:

• Excellent test-retest reliability (ICC = 0.97)

• Excellent test-retest reliability (r = 0.983)

Stroke:
(n = 25; mean age = 72 years; stroke onset = 2 to 6 years, Chronic Stroke)
Test-retest assessed three times within a single session:

• Excellent test-retest reliability (ICC = 0.95 to 0.99)

• Excellent reliability for comfortable (ICC = 0.94) and fast (ICC = 0.97) gait speeds 

TBI:

• Excellent between day reliability at comfortable (ICC = 0.95) and fast speeds (ICC = 0.96)

•  Excellent test-retest reliability (r = 0.97 - 0.99)

Interrater/Intrarater Reliability

Healthy Adults:

(n = 28 healthy adults; mean age = 56.43 (13.82) years; Healthy Adults)

• Excellent interrater reliability; (ICC = 0.980) 

SCI:

• Excellent intrarater reliability (r = 0.983, p < 0.001)
• Excellent interrater reliability (r = 0.974, p < 0.001)
• Bland-Altman plots indicate reliability Excellent when completed in under 40 seconds, but reliability decreases with marginal walkers requiring > 40 seconds to complete 

(Scivoletto et al, 2011; n = 37; median age = 58.5 (range 19 - 77) years; median time from onset = 24 (range 6 - 109) months; AIS D = 35, C = 2; Median WISCI = 16, utilized 2 methods, measured 10 m with a static start and measured middle 10 m of 14 m walkway to include acceleration and deceleration, Chronic SCI)
For both methods:

• Excellent interrater reliability (ICC > 0.95)
• Excellent intrarater reliability (ICC > 0.98) 

Stroke:

• Excellent intrarater reliability; ICC = 0.87 to 0.88 

(Wolf et al, 1999; n = 28 with history of stroke; mean age = 56.04 (12.80) years; mean time since lesion = 13.59 (12.30) months, Chronic Stroke)

• Excellent interrater reliability; (ICC = 0.998) 

TBI:

(Tyson & Connell, 2009; review of seventeen measures; n = 12 mobile TBI patients, TBI)

• Excellent interrater reliability (ICC = 0.99) 

Validity

Multiple Sclerosis:

(Paltamaa et al, 2007; n = 120; mean age = 45.0 (10.8) years; mean duration since symptom onset 12.3 (8.8) years, MS)

Predictive Validity 

• Excellent correlation with dependence in self-care (r = 0.60 - 0.87) at comfortable speed
• Adequate to Excellent correlation with dependence in mobility (r = 0.34 - 0.74) at comfortable speed
• Adequate to excellent correlation with dependence in domestic life (r = 0.34 - 0.81) at comfortable speed

Stroke:
(Tyson & Connell, 2009; n = 40, review article of 17 measures, Stroke)

Predictive Validity 

• Excellent correlation with dependence in instrumental activities of daily living (r = 0.76)
• Excellent correlation with Barthel Index (r = 0.78

Healthy Adults:

• Poor correlation with BBT (r = 0.052)
• Adequate correlation with FRT (r = 0.307) 

Hip Fracture:

• Excellent correlation with 6MWT (correlation coefficient = 0.82)
• Adequate correlation with LE strength (r = 0.51)
• Adequate correlation with LE power (r = 0.58)
• Poor correlation with hip pain (r = -0.23)
• Poor correlation with bodily pain (r = 0.30)
• Poor correlation with vitality (r = 0.26)
• Adequate correlation with physical role (r = 0.54)
• Adequate correlation with social role (r = 0.42) 

SCI:

Convergent Validity:

• Excellent correlation between the TUG and 10MWT (r = 0.89, n = 70)
• Excellent correlation between 10MWT and 6MWT (ρ = -0.95, n = 62)
• Subgroup comparisons of WISCI II and 10MWT
• Excellent correlation between WISCI II and 10MWT when testing individuals with WISCI II scores 11 - 20 (p = -0.68, n = 47)
• Poor correlation between the WISCI II and 10MWT when testing individuals with WISCI II scores 0 - 10 (r = -0.24, n = 20)
• Adequate but not significant correlation between WISCI II (0-8,10,11,14,17), dependent walkers (r = -0.35, n = 15)
• Adequate correlation between WISCI II (9,12,13,15,16,18-20) independent walkers (r = -0.48, n = 43)
• Overall, improved validity in individuals who are less impaired, higher walking ability, and do not require assistance 

Stroke:

• Excellent correlation between comfortable gait speed and TUG (ICC = -0.84), FGS (ICC = 0.92), Stair climbing ascend (SCas) (ICC = -0.81), Stair climbing descend (SCde) (ICC = -0.82), 6MWT (ICC = 0.89)
• Excellent correlation between fast gait speed and TUG (ICC = -0.91), CGS (ICC = 0.88), SCas (ICC = -0.84), SCde (ICC = -0.87) and 6MWT (ICC = 0.95) 

Responsiveness

Geriatrics:

• Small meaningful change = 0.05 m/s
• Substantial meaningful change = 0.10 m/s 

SCI:

• Smallest real difference = 0.13 m/s
• Mean change between 1 and 3 months post injury, effect size = 0.92
• Mean change between 3 and 6 months post injury, effect size = 0.47 

Stroke:

• Small meaningful change = 0.05 m/s
• Substantial meaningful change = 0.10 m/s 

 Reference link:

• http://www.physio-pedia.com/10_Metre_Walk_Test