Highlights
- •F8WT and L test is a valid and reliable physical performance test in MS patients without mobility aids.
- •L and 8 shaped pathways would provide more comprehensive practical gait evaluation than horizontal pathways.
- •Both tests do not require expensive equipment and can be applied comfortably in a clinical setting.
Abstract
Purpose
To our knowledge, no other studies have demonstrated the reliability and validity
of the Figure of Eight Walking Test (F8WT) and L Test in patients with multiple sclerosis
(MS). The aim of the study was to prove the test-retest reliability and concurrent
validity of the F8WT and L Test in patients with MS.
Methods
A cross-sectional study was conducted with 52 patients with MS. A clinical neurologist
evaluated patients by Expanded Disability Status Scale (EDSS). Participants completed
the F8WT, L Test, Timed Up and Go Test (TUG), and Timed 25-Foot Walk Test (T25FW)
in the first assessment session. Then, the F8WT and L Test was retested one hour later.
The same evaluator completed all of the assessments.
Results
The ICC of both tests were excellent (ICCF8WT: 0.972, ICCL Test: 0.986). F8WT and L test measurement did not show a systematic bias and were within
the agreement limits. The Standard Error of Measurement (SEM95) and Minimal Detectable Change (MDC95) values of the F8WT was 0.58 and 1.60, respectively. Besides, L Test's SEM95 and MDC95 were 0.59 and 1.63. The correlation between F8WT with TUG, T25FW and EDSS was 0.849,
0.810 and 0.453. On the other hand, the L test's correlation coefficient with TUG,
T25FW and EDSS 0.682, 0.706 and 0.535, respectively (p < 0.01). Individuals with “EDSS ≤ 1″ had statistically significantly better L-test
and F8WT scores than those with “EDSS: 1 to 4.5″ (p < 0.01).
Conclusion
F8WT and L Test is a valid and reliable physical performance test in MS patients without
mobility aids. Both tests demonstrate advanced gait assessment in L and 8 shaped pathways
to provide more comprehensive evaluation than horizontal pathways.
Keywords
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References
- Turning is an important marker of balance confidence and walking limitation in persons with multiple sclerosis.PLoS One. 2018; 13e0198178
- User's guide to correlation coefficients.Turkish J. Emerg. Med. 2018; 18: 91-93
- Confidence limits for intraclass reliability coefficients.Meas. Phys. Educ. Exerc. Sci. 2001; 5: 179-188
- Sit-to-stand biomechanics of individuals with multiple sclerosis.Clin. Biomech. 2015; 30: 788-794
- Balance, gait, and falls in multiple sclerosis.Handb. Clin. Neurol. 2018; 159: 237-250
- Investigation of the validity and reliability of the L test in children with cerebral palsy.Physiother. Theory Pract. 2022; 38: 182-188
- Gait deficits in people with multiple sclerosis: a systematic review and meta-analysis.Gait Posture. 2017; 51: 25-35
- The L test of functional mobility: measurement properties of a modified version of the timed “up & go” test designed for people with lower-limb amputations.Phys. Ther. 2005; 85: 626-635
- Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses.Behav. Res. Methods. 2009; 41: 1149-1160
- G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.Behav. Res. Methods. 2007; 39: 175-191
- Effect size estimates: current use, calculations, and interpretation.J. Exp. Psychol. Gen. 2012; 141: 2
- Reliability and minimal detectable change in the gait assessment and intervention tool in patients with multiple sclerosis.PM&R. 2020; 12: 685-691
- The reliability and validity of the l-test in people with Parkinson's disease.Physiotherapy. 2019; 105: 84-89
- Standard error of measurement: an NCME instructional module on.Educ. Meas. Issues Pract. 1991; 10: 33-41
- Walking skill can be assessed in older adults: validity of the Figure-of-8 Walk Test.Phys. Ther. 2010; 90: 89-99
- Reliability of power in physical performance tests.Sports Med. 2001; 31: 211-234
- The clinical correlates of the chair sit to stand performance in people with multiple sclerosis.Physiother. Theory Pract. 2021; : 1-12
- Reliability and validity of the L test in participants with chronic stroke.Physiotherapy. 2015; 101: 161-165
- Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurology. 1983; 33 (-1444): 1444
- Gait stability at early stages of multiple sclerosis using different data sources.Gait Posture. 2020; 77: 214-217
- The Figure-of-8 Walk Test used to detect the loss of motor skill in walking among persons with Parkinson’s disease.Physiother. Theory Pract. 2022; 38: 552-560
- COSMIN Checklist Manual.University Medical Center, Amsterdam2012
- Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis.Mult. Scler. J. 2017; 23: 704-710
- Confirmation and extension of the validity of the multiple Sclerosis walking scale-12 (MSWS-12).J. Neurol. Sci. 2008; 268: 69-73
- Test–retest reliability of the L-Test in patients with advanced knee osteoarthritis.Physiother. Theory Pract. 2021; : 1-5https://doi.org/10.1080/09593985.2021.1967539
- Effects of a vestibular stimulation training program on the gait of chronic stroke patients.J. Korean Soc. Phys. Med. 2019; 14: 35-41
- Measurement properties of the L test for gait in hospitalized elderly.Am. J. Phys. Med. Rehabil. 2007; 86: 463-468
- The reliability and validity of modified Four-Square-Step-Test and Step-Test in older adults.Phys. Occup. Ther. Geriatr. 2021; 39: 397-408
- Nutrition and diet in the clinical management of multiple sclerosis.J. Hum. Nutr. Diet. 2001; 14: 349-357
- Getting serious about test–retest reliability: a critique of retest research and some recommendations.Qual. Life Res. 2014; 23: 1713-1720
- Foundations of Clinical research: Applications to Practice.Pearson/Prentice Hall Upper Saddle River, NJ, 2009
- COSMIN guideline for systematic reviews of patient-reported outcome measures.Qual. Life Res. 2018; 27: 1147-1157
- Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions.Disabil. Rehabil. 2021; 43: 1323-1332
- Fatigue in multiple sclerosis: current understanding and future directions.J. Rehabil. Res. Dev. 2002; 39: 211-224
- Validity of the timed up and go test as a measure of functional mobility in persons with multiple sclerosis.Arch. Phys. Med. Rehabil. 2016; 97: 1072-1077
- Fatigue in multiple sclerosis.Phys. Med. Rehabil. Clin. N. Am. 2009; 20: 363-372
- Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria.Lancet Neurol. 2018; 17: 162-173
- A preliminary investigation of the effects of obstacle negotiation and turning on gait variability in adults with multiple sclerosis.Sensors. 2021; 21: 5806
- The Figure-of-Eight Walk test: reliability and associations with stroke-specific impairments.Disabil. Rehabil. 2013; 35: 1896-1902
- Reliability, concurrent validity and minimal detectable change of the L test in patients with total knee arthroplasty.Disabil. Rehabil. 2021; : 1-5https://doi.org/10.1080/09638288.2021.1871670
Article info
Publication history
Published online: June 25, 2022
Accepted:
June 24,
2022
Received in revised form:
June 14,
2022
Received:
May 1,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
