Are the 10 meter and 6 minute walk tests redundant in patients with spinal cord injury?
OBJECTIVE
To evaluate the relationship and redundancy between gait speeds measured by the 10 Meter Walk Test (10MWT) and 6 Minute Walk Test (6MWT) after motor incomplete spinal cord injury (iSCI). To identify gait speed thresholds supporting functional ambulation as measured with the Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI).


METHODS
Prospective observational cohort.


METHODS
Seven outpatient rehabilitation centers from the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN).


METHODS
249 NRN patients with American Spinal Injury Association Impairment Scale (AIS) level C (n = 20), D (n = 179) and (n = 50) iSCI not AIS evaluated, from February 2008 through April 2011.


METHODS
Locomotor training using body weight support and walking on a treadmill, overground and home/community practice.


METHODS
10MWT and 6MWT collected at enrollment, approximately every 20 sessions, and upon discharge.


RESULTS
The 10MWT and 6MWT speeds were highly correlated and the 10MWT speeds were generally faster. However, the predicted 6MWT gait speed from the 10MWT, revealed increasing error with increased gait speed. Regression lines remained significantly different from lines of agreement, when the group was divided into fast (≥0.44 m/s) and slow walkers (<0.44 m/s). Significant differences between 6MWT and 10MWT gait speeds were observed across SCI-FAI walking mobility categories (Wilcoxon sign rank test p<.001), and mean speed thresholds for limited community ambulation differed for each measure. The smallest real difference for the 6MWT and 10MWT, as well as the minimally clinically important difference (MCID) values, were also distinct for the two tests.


CONCLUSIONS
While the speeds were correlated between the 6MWT and 10MWT, redundancy in the tests using predictive modeling was not observed. Different speed thresholds and separate MCIDs were defined for community ambulation for each test.
Human Performance and Engineering Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America; Department of Physical Medicine and Rehabilitation, Rutgers, New Jersey Medical School, Newark, New Jersey, United States of America.
Gail F
GF
Forrest
Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, United States of America.
Karen
K
Hutchinson
Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, Kentucky, United States of America; Kentucky Spinal Cord Research Center, University of Louisville, Louisville, Kentucky, United States of America.
Douglas J
DJ
Lorenz
Wexner Medical Center at the Ohio State University- Dodd Hall, Columbus, Ohio, United States of America.
Jeffrey J
JJ
Buehner
Hulse Spinal Cord Injury Lab and Crawford Research Institute, Shepherd Center, Atlanta, Georgia, United States of America.
Leslie R
LR
Vanhiel
State University of New York at Stony Brook, School of Health Technology and Management, Research and Development Park, Rehabilitation Research and Movement Performance Laboratory, Stony Brook, New York, United States of America.
Sue Ann
SA
Sisto
The Ohio State University, School of Allied Medical Professions, Center for Brain and Spinal Cord Repair, Columbus, Ohio, United States of America.
D Michele
DM
Basso
D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D016896:Treatment Outcome; D016138:Walking