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Inter and Intra Rater Reliability of the 10 Meter Walk Test in the Community Dweller Adults with Spastic Cerebral Palsy

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      We aimed to investigation the intra-rater and inter-raters reliability of the 10 meter walk test (10 MWT) in adults with spastic cerebral palsy (CP).

      Materials & Methods

      Thirty ambulatory adults with spastic CP in the summer of 2014 participated (19 men, 11 women; mean age 28 ± 7 yr, range 18- 46 yr). Individuals were non-randomly selected by convenient sampling from the Ra’ad Rehabilitation Goodwill Complex in Tehran, Iran. They had GMFCS levels below IV (I, II, and III). Retest interval for inter-raters study lasted a week. During the tests, participants walked with their maximum speed. Intraclass correlation coefficients (ICC) estimated reliability.


      The 10 MWT ICC for intra-rater was 0.98 (95% confidence interval (CI) 0.96-0.99) for participants, and >0.89 in GMFCS subgroups (95% confidence interval (CI) lower bound>0.67). The 10 MWT inter-raters’ ICC was 0.998 (95% confidence interval (CI) 0/996-0/999), and >0.993 in GMFCS subgroups (95% confidence interval (CI) lower bound>0.977). Standard error of the measurement (SEM) values for both studies was small (0.02< SEM< 0.07).


      Excellent intra-rater and inter-raters reliability of the 10 MWT in adults with CP, especially in the moderate motor impairments (GMFCS level III), indicates that this tool can be used in clinics to assess the results of interventions.

      Related collections

      Most cited references 25

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      Development and reliability of a system to classify gross motor function in children with cerebral palsy.

      To address the need for a standardized system to classify the gross motor function of children with cerebral palsy, the authors developed a five-level classification system analogous to the staging and grading systems used in medicine. Nominal group process and Delphi survey consensus methods were used to examine content validity and revise the classification system until consensus among 48 experts (physical therapists, occupational therapists, and developmental pediatricians with expertise in cerebral palsy) was achieved. Interrater reliability (kappa) was 0.55 for children less than 2 years of age and 0.75 for children 2 to 12 years of age. The classification system has application for clinical practice, research, teaching, and administration.
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        Gait changes in older adults: predictors of falls or indicators of fear.

         B Maki (1997)
        To determine, in a cohort of ambulatory older adults, whether spatial-temporal measures of foot placement during gait can predict the likelihood of future falls or whether these measures are more likely to be indicative of adaptations associated with pre-existing fear of falling. Prospective cohort study. Baseline gait measurements were performed in a gait and balance laboratory; subsequent history of falling was monitored prospectively for 1 year in two self-care facilities. Fourteen male and 61 female consecutive volunteers (mean age = 82, SD = 6) who were independent in activities of daily living and able to walk 10 m unaided. Spatial gait parameters were derived from digitized "footprints"; temporal parameters were derived using footswitches. A clinical activity-based gait assessment was also performed. The dependent variables were pre-existing fear of falling (reported at baseline) and future falling (experiencing one or more falls during the 1-year follow-up). Reduced stride length, reduced speed, increased double-support time, and poorer clinical gait scores were associated with fear but showed little evidence of an independent association with falling. Conversely, increased stride-to-stride variability in stride length, speed, and double-support was associated independently with falling but showed little evidence of relationship to fear. Increased stride width showed some evidence of association with both falling and fear. Stride-to-stride variability in speed was the single best independent predictor of falling. Changes in gait cited previously as risk factors for falling, i.e., decreased stride length and speed and prolonged double support, may in fact be stabilizing adaptations related to fear of falling. Stride-to-stride variability in the control of gait is an independent predictor of falling and may be a useful measure for identifying high-risk individuals and evaluating preventive interventions. Stride width may also be a useful outcome measure. Contrary to common expectation, a wider stride does not necessarily increase stability but instead seems to predict an increased likelihood of experiencing falls.
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          Comfortable and maximum walking speed of adults aged 20—79 years: reference values and determinants


            Author and article information

            [1 ]Department of Physiotherapy, Iranian center of excellence in Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
            Author notes
            Corresponding Author: Nourizadeh Dehkordi SH. PhD, Mirdamad, Mother Sq, Madkaran St, School of Rehabilitation Sciences, Iran University of Medical Sciences Tehran, Iran, Tel: +98-21- 22227124, Email:
            Iran J Child Neurol
            Iran J Child Neurol
            Iranian Journal of Child Neurology
            Shahid Beheshti University of Medical Sciences (Tehran, Iran )
            Winter 2017
            : 11
            : 1
            : 57-64
            28277557 5329761 ijcn-17-057

            This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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