Walk-12 test identifies poststroke perceived limitations

By Ingrid Grasmo

Perceived limitations in walking ability among patients who experience stroke can be assessed using the Walking Impact Scale (Walk-12), show study findings.

In clinical practice, gait performance is usually assessed with quantitative measures that have been shown as reliable for chronic stroke, but are often time-consuming and do not provide a complete clinical picture.

"From a rehabilitation perspective, it is also important to focus on patients' own perceptions of their walking ability," say Christina Brogårdh (Lund University, Sweden) and co-authors.

Indeed, a greater knowledge of self-perceived consequences in everyday life following stroke can enable clinicians to design more individually targeted rehabilitation interventions, they remark.

For the study, the researchers assessed gait performance among 50 patients aged an average of 64 years who had experienced a stroke approximately 3.5 years previously.

Tools used to assess gait performance included the Timed 'Up and Go' test, 10-m Comfortable Gait Speed and Fast Gait Speed tests, and the 6-Minute Walk Test. Self-reported walking ability was assessed using the Walk-12 test.

Walking aids were used by approximately half of patients, but less than 20% used an ankle-foot orthosis. Limitations in walking ability as a result of stroke were reported by 94% of all patients, with only 6% reporting no limitations at all.

Furthermore, 50% of patients required support when walking indoors or outdoors and over half of all patients had moderate-to-severe limitations relating to standing or walking, climbing stairs, walking speed and distance, concentration, and effort, in addition to gait quality aspects.

Three-quarters of all patients reported that their ability to run was extremely limited and 20% said that their walking speed, walking quality, and concentration when walking were extremely affected.

Findings from the Walk-12 test revealed an average score of 53%, where a score of 0% indicates no self-perceived limitation in walking and 100% indicates maximum limitation. Mean times on the Timed Up & Go, Comfortable Gait Speed test, Fast Gait Speed test, and 6-Minute Walk Test were 16.5 seconds, 13.6 seconds, 11.5 seconds, and 330 m, respectively.

A significant association was seen between the Walk-12 and the four gait performance tests, with the highest correlations observed between the Walk-12 and the 6-Minute Walk Test, followed by the Comfortable Gait Speed Test.

"Because the Walk-12 reflects broader dimensions than the gait performance tests, it can be used as a complement when evaluating walking ability in ambulatory individuals with chronic stroke," the authors conclude in Physical Medicine and Rehabilitation.

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