Is the Walking Adaptability Ladder test for Kids (WAL-K) reliable and valid in ambulatory children with Cerebral Palsy?

Abstract

Purpose Walking adaptability is essential for children to participate in daily life. We studied whether the Walking Adaptability Ladder test for Kids (WAL-K) is reliable and valid for assessing walking adaptability in 6–12 year old ambulatory children with Cerebral Palsy (CP). Materials and methods Thirty-six children with CP (26 GMFCS-level I, 10 GMFCS-level II) completed the single and double run of the WAL-K. Intra- and inter-rater reliability were determined by Intraclass Correlation Coefficients (ICCs). Construct validity was determined by comparing WAL-K scores between 122 typically developing (TD) and CP children taking age into account, comparing WAL-K scores between CP children in GMFCS-levels I and II, and correlating WAL-K scores with scores of the 10 times 5 m Sprint Test (10 × 5mST). Results ICCs for reliability varied between 0.997 and 1.000. WAL-K scores were significantly higher (i.e., worse) in CP children compared to TD children (p < 0.001), and in children in GMFCS-level II compared to GMFCS-level I (p = 0.001). Significant positive correlations were found between the WAL-K and 10 × 5 mST (single run r = .89, double run r = .84). Conclusions The WAL-K shows to be a promising reliable, valid, and easy-to-use tool for assessing walking adaptability in children with CP. Responsiveness to change has yet to be evaluated.