The Figure-of-Eight Walk test: Reliability and associations with stroke-specific impairments

Objectives: To investigate (1) the intra-rater, inter-rater and test-retest reliabilities of the Figure-of-Eight Walk (F8W) test times; (2) its correlation with other stroke-specific impairments; and (3) the cut-off scores best discriminating patients with stroke from the healthy elderly. Design: Cross-sectional study. Setting: University-based rehabilitation centre. Participants: A convenience sample of 64 subjects: 35 subjects with chronic stroke and 29 healthy elderly. Main Outcome Measures: F8W test times, Fugl-Meyer Motor Assessment for the lower extremities (FMA-LE), hand-held dynamometer measurements of bilateral hip abductor and knee extensor isometric muscle strength, Five times Sit to Stand Test (FTSTST) times, 10-Meter Walk Test (10MWT), Timed Up and Go Test (TUGT) times, Berg Balance Scale (BBS) and Activities-specific Balance Confidence Scale (ABC) scores. Results: Excellent intra-rater, inter-rater and test-retest reliabilities (intra-class correlation coefficient (ICC) range 0.944-0.999) of F8W test times were found. The F8W test times were also found to be significantly associated with FMA-LE, BBS, FTSTST, TUG scores and 10MWT. No significant correlation was found between F8W test times and either leg strength or ABC results. A F8W test time of 8.2 s was found to be the most representative for discriminating between healthy elderly and stroke subjects, with a sensitivity of 100% and a specificity of 89.7%. Conclusions: The F8W test time is a reliable measurement tool, which is able to differentiate the patients with stroke and healthy elderly subjects and correlated well with stroke-specific impairments and walking tests. The F8W is a reliable measurement tool for assessing the advanced walking performance of subjects with chronic stroke.Implication for RehabilitationThe F8W test times have excellent intra-rater, inter-rater and test-retest reliabilities in patients with chronic stroke.The F8W test times were also found to be significantly associated with FMA-LE, BBS, FTSTST, TUG scores and 10MWT.A F8W test time of 8.2 s was found to be the most representative for discriminating between healthy elderly and stroke subjects, with a sensitivity of 100% and a specificity of 89.7%.The F8W test time is a reliable and valid measure in assessing the advanced walking skill in patients with stroke.