Outcome Measures for Gait and Ambulation in the Spinal Cord Injury Population

Abstract

Background: At the 2006 National Institute on Disability and Rehabilitation Research (NIDRR) sponsored pre-conference on spinal cord injury (SCI) outcomes, several gait and ambulation measures were evaluatedfor utility in clinical practice, validity, and reliability as research measurement tools. The Conference Subcommittee on Gait and Ambulation chose to review the Walking Index for Spinal Cord Injury II (WISCIII), 50-Foot Walk Test (50FTWT), 6-Minute Walk Test (6MWT), 10-Meter Walk Test (1 OMWT), andFunctional Independence Measure-Locomotor (FIM-L).Methods: A subcommittee of international experts evaluated each instrument for test construct,administration, population applicability, reliability, sensitivity to change, and validity. Evaluations for eachoutcome measure were compiled, distributed to the whole committee, and then further reviewed withaddition of comments and recommendations for consensus. An audience of experts voted on the validity and usefulness of each measure.Results: WISCI II and 1 OMWT were found to be the most valid and clinically useful tests to measureimprovement in gait for patients with SCI. FIM-L had little utility and validity for research in SCI. 6MWT and50FTWT were found to be useful but in need of further validation or changes for the SCI population.Conclusion: A combination of the 1 OMWT and WI SCI II would provide the most valid measure of improvement in gait and ambulation in as much as objective changes of speed, and functional capacity allow for interval measurement. To provide the most comprehensive battery, however, it will be importantto include a measure of endurance such as the 6MWT. Further validation and study should be devoted toWISCI II, 1 OMWT, and 6MWT as primary outcome measuresfor gait in SCI.