AUTHOR=Ng Shamay S. M. , Liu Tai-Wa , Tsoh Joshua , Chen Peiming , Cheng Tony S. , Cheung Marco C. H. , Leung Anthony H. H. , Ng Liam L. Y. , So Ken Y. K. , Tse Mimi M. Y. 

TITLE=Psychometric Properties of the Trail Walking Test for People With Stroke

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.821670

DOI=10.3389/fneur.2022.821670

ISSN=1664-2295

ABSTRACT=<sec><title>Objective</title><p>To investigate (i) the inter-rater and test–retest reliability of the trail walking test (TWT) and the minimum detectable change in the TWT completion time; (ii) the correlations between the TWT completion time and stroke-specific impairments; and (iii) the cutoff TWT completion time to distinguish between people with stroke and healthy older adults according to dual-tasking ambulation ability.</p></sec><sec><title>Design</title><p>Cross-sectional study.</p></sec><sec><title>Setting</title><p>University-based rehabilitation center.</p></sec><sec><title>Participants</title><p>In total, 104 people with stroke and 53 healthy older adults.</p></sec><sec><title>Main Outcome Measures</title><p>The TWT, the Fugl–Meyer Assessment of Lower Extremity (FMA-LE), the ankle muscle strength test, the limit of stability (LOS) test, the Berg Balance Scale (BBS), the Timed Up and Go test (TUG), and the Community Integration Measure (CIM).</p></sec><sec><title>Results</title><p>The mean TWT completion time in subjects with stroke was 124.906 s. The TWT demonstrated excellent inter-rater reliability [intraclass correlation (ICC) = 0.999] and good test–retest reliability (ICC = 0.876) in people with stroke. The TWT performance demonstrated significant negative correlations with the FMA-LE scores (<italic>r</italic> = −0.409), LOS movement velocity (affected and unaffected sides; <italic>r</italic> = −0.320 and −0.388, respectively), and LOS endpoint excursion (affected and unaffected sides; <italic>r</italic> = −0.357 and −0.394, respectively); a significant positive correlation with the LOS reaction time (affected side; <italic>r</italic> = 0.256); a moderate negative correlation with the BBS scores (<italic>r</italic> = −0.72); and an excellent positive correlation with the TUG completion time (<italic>r</italic> = 0.944). The receiver operating characteristic curve analysis revealed that an optimal cutoff of 69.61 s for the TWT completion time had an outstanding diagnostic power to distinguish between people with stroke and healthy older adults (area under the curve = 0.919) with high sensitivity (88.5%) and specificity (83.0%).</p></sec><sec><title>Conclusion</title><p>Results of our preliminary study demonstrated that the TWT is a reliable, valid, sensitive, and specific clinical test for evaluating dual-tasking ambulation ability in people with stroke aged 45 years or above and without cognitive impairments. It can differentiate the dual-tasking ambulation ability between people with stroke and healthy older adults.</p></sec>