(van Hedel et al 2006, n = 22, incomplete SCI who could ambulate within the 1st month post SCI, measured at 1 mo, 3 mo, 6 mo, and 12 mo post, middle 10 m of 14 m walk used, SCI)

10 metersto cm

Musselman, K. E., Fouad, K., et al. (2009). "Training of walking skills overground and on the treadmill: case series on individuals with incomplete spinal cord injury." Phys Ther 89(6): 601-611. Find it on PubMed

Schenkman, M., Cutson, T. M., et al. (1997). "Reliability of impairment and physical performance measures for persons with Parkinson's disease." Phys Ther 77(1): 19-27. Find it on PubMed

10 metersto feet

Reuben, D. B., Magasi, S., et al. (2013). "Motor assessment using the NIH Toolbox." Neurology 80(11 Supplement 3): S65-S75.

Flansbjer, U. B., Holmback, A. M., et al. (2005). "Reliability of gait performance tests in men and women with hemiparesis after stroke." J Rehabil Med 37(2): 75-82. Find it on PubMed

Musselman, K. (2007). "Clinical significance testing in rehabilitation research: what, why, and how?" Physical Therapy Reviews 12(4): 287-296.

van Hedel, H. J., Dietz, V., et al. (2007). "Assessment of walking speed and distance in subjects with an incomplete spinal cord injury." Neurorehabil Neural Repair 21(4): 295-301. Find it on PubMed

(Hollman et al, 2008, n = 16, participants aged 77.9 (9.0) years, tested at a mean of 4.7 (2.0) days, range = 2 to 8 days, after surgical fixation of their hip fractures, after rest a second trial under the same parameters was conducted, Hip Fracture)

Paltamaa, J., Sarasoja, T., et al. (2007). "Measures of physical functioning predict self-reported performance in self-care, mobility, and domestic life in ambulatory persons with multiple sclerosis." Archives of physical medicine and rehabilitation 88(12): 1649-1657. Find it on PubMed

For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

Severinsen, K., Jakobsen, J. K., et al. (2011). "Normalized muscle strength, aerobic capacity, and walking performance in chronic stroke: a population-based study on the potential for endurance and resistance training." Arch Phys Med Rehabil 92(10): 1663-1668. Find it on PubMed

Pirpiris, M., Wilkinson, A., et al. (2003). "Walking speed in children and young adults with neuromuscular disease: comparison between two assessment methods." Journal of Pediatric Orthopaedics 23(3): 302. Find it on PubMed

(van Hedel et al, 2005; n = 22; mean age = 45.5 (16.7) years; method not specified, "measures the time it takes a patient to walk 10m" SEM calculated by Lam et al, 2008, SCI)

Abbreviations: BBS, Berg Balance Scale; 2MWT, 2-min walk test; SCI-FAI, Spinal Cord Injury Functional Ambulation Inventory, TUG, Timed up and go; WISCI II, Walking Index for Spinal Cord Injury (version II)

(van Hedel et al, 2007; Longitudinal study looking at 6min and 10MWT at 1, 3, and 6 mo post injury, incomplete SCI who were able to ambulate 10m within 3 months post SCI n = 51, 22 tetraplegic, 29 paraplegic; cross sectional study  n = 18 incomplete SCI, acute and chronic range 2 weeks to 8 years AIS C or D, utilized middle 10 m of 14 m walk; Acute; Subacute, SCI)

Hollman, J. H., Beckman, B. A., et al. (2008). "Minimum detectable change in gait velocity during acute rehabilitation following hip fracture." J Geriatr Phys Ther 31(2): 53-56. Find it on PubMed

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**No statistical difference was observed in gait speed when completing 10MWT in therapy gymnasium vs. community environment (p = 0.663)

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(vanLoo and Moseley, 2004; n = 13; mean age = 32.5 (11.3) years; average time post injury 11.9 (15.7) months; mean initial GCS 5.8 (2.9); mean PTA 43.8 (39.1) days, walked 14 meters with middle 10 timed, TBI)

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Lam, T., Noonan, V., et al. (2007). "A systematic review of functional ambulation outcome measures in spinal cord injury." Spinal Cord 46(4): 246-254. Find it on PubMed

Watson, M. J. (2002). "Refining the ten-metre walking test for use with neurologically impaired people." Physiotherapy 88(7): 386-397.

Latham, N., Mehta, V., et al. (2008). "Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients?" Archives of physical medicine and rehabilitation 89(11): 2146-2155. Find it on PubMed

(Olmos et al, 2008; n = 18; all participants were AIS D; time post injury = 6 months; tested three times each with a 60 minute interval between test run, method not specified, "measures the time it takes a patient to walk 10 m", Chronic SCI)

Wolf, S. L., Catlin, P. A., et al. (1999). "Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile." Phys Ther 79(12): 1122-1133. Find it on PubMed

Initially reviewed by the Rehabilitation Measures Team in 2010; Updated with references from the Alzheimer's Disease population by Jenna Poulter, SPT and Mackenzie Riebel, SPT in 2011; Updated with references from the Spinal Cord Injury population by Candy Tefertiller, PT, DPT, ATP, NCS and Jennifer H. Kahn, PT, DPT, NCS and the SCIEDGE task force of the Neurology section of the APTA in 2012; Updated with references from the Traumatic Brain Injury population by the TBIEDGE task force of the Neurology section of the APTA in 2012; Updated by Kathleen Chizewski, SPT and Jessica Wierdak, SPT in 11/2012; Updated with references from the Parkinson's Disease population by Jeffrey Hoder, PT, DPT, NCS and the PD EDGE tast force of the Neurology section of the APTA in 2013.Updated by Karen Lambert PT, MPT, NCS and Linda B. Horn PT, DScPT, MHS, NCS of the VEDGE task force for the Neurology section of the APTA in 2013.

Jackson, A. B., Carnel, C. T., et al. (2008). "Outcome measures for gait and ambulation in the spinal cord injury population." J Spinal Cord Med 31(5): 487-499. Find it on PubMed

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How far IS10 metersto walk

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(Scivoletto et al, 2011; n = 37; median age = 58.5 (range 19 - 77) years; median time from onset = 24 (range 6 - 109) months; AIS D = 35, C = 2; Median WISCI = 16, utilized 2 methods, measured 10 m with a static start and measured middle 10 m of 14 m walkway to include acceleration and deceleration, Chronic SCI)

Collen, F., Wade, D., et al. (1990). "Mobility after stroke: reliability of measures of impairment and disability." Disability & Rehabilitation 12(1): 6-9. Find it on PubMed

(Moseley et al, 2004, n = 10, mean age 31.9 (14.2) years, mean days post injury = 56.4 (25.5); mean duration of PTA = 26.6 (8.7) days, 14 m walk with central 10 m timed, TBI)

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(Latham et al, 2008; aged > 65 years; within 17 days of surgical repair of hip fracture; sample included Norway, United Kingdom, Sweden, Israel, Germany, United States, Denmark, Spain; gait speed tested over 4 meters of walking after 12 weeks, Hip Fracture)

Steffen, T. and Seney, M. (2008). "Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism." Physical Therapy 88(6): 733-746. Find it on PubMed

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(Lemay & Nadeau, 2010; n = 32; all participants were AIS D; mean age = 47.9 (12.8); mean time post lesion 77.2 (44.3) days, middle 10 m of 15 m timed, Acute SCI)

van Hedel, H. J., Wirz, M., et al. (2005). "Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests." Archives of Physical Medicine and Rehabilitation 86(2): 190-196. Find it on PubMed

No significant difference noted when comparing static and dynamic starts in chronic incomplete SCI (Scivoletto et al, 2011)

Jackson, A. B., Carnel, C. T., et al. (2008). "Outcome measures for gait and ambulation in the spinal cord injury population." Journal of Spinal Cord Medicine 31(5): 487-499. Find it on PubMed

(Steffen & Seney, 2008; n = 37; mean age = 71; community dwelling adults with Parkinsonism; mean Hoehn & Yahr Stage of 2 (ranged 1 - 4), Parkinson's Disease)

A combination of the 10MWT and WISCI II were recommended by an expert committee assembled by the National Institute on Disability and Rehabilitation Research (NIDRR) to provide the most valid measure of improvement in ambulation and gait in SCI (Jackson et al, 2008)

Bowden, M., Balasubramanian, C., et al. (2008). "Validation of a speed-based classification system using quantitative measures of walking performance poststroke." Neurorehabilitation and neural repair 22(6): 672. Find it on PubMed

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van Hedel, H., Wirz, M., et al. (2006). "Improving walking assessment in subjects with an incomplete spinal cord injury: responsiveness." Spinal Cord 44(6): 352-356.

Fritz, S. and Lusardi, M. (2009). "White paper:“walking speed: the sixth vital sign”." Journal of geriatric physical therapy 32(2): 2-5.

Ambulation ability has been correlated with gait speed (Perry et al, 1995); changes in gait speed that result in a transition to a higher category of ambulation classification resulted in better function and quality of life (Schmid et al, 2007); ambulation ability that is predicted by gait speed is a reliable method of classifying patients (Bowden et al, 2008)

Perry, J., Garrett, M., et al. (1995). "Classification of walking handicap in the stroke population." Stroke 26(6): 982. Find it on PubMed

Schmid, A., Duncan, P., et al. (2007). "Improvements in speed-based gait classifications are meaningful." Stroke 38(7): 2096. Find it on PubMed

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Bohannon, R.W.; Andrews, A. W. (2011). "Normal walking speed: a descriptive meta-analysis". Physiotherapy 97: 182-189. Find it on PubMed

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

(Perera et al, 2006; n = 100 subacute stroke survivors in an interventional trial; mean age = 69.8 (10.3) years; two-arm randomized trial of a 3-month program of therapeutic exercise in stroke survivors, Stroke)

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Olmos, L. E., Freixes, O., et al. (2008). "Comparison of gait performance on different environmental settings for patients with chronic spinal cord injury." Spinal Cord 46(5): 331-334. Find it on PubMed

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(Wolf et al, 1999; n = 28 with history of stroke; mean age = 56.04 (12.80) years; mean time since lesion = 13.59 (12.30) months, Chronic Stroke)

(Watson et al, 2002, n = 10 patients with TBI who were walking independently with or without walking aids; n = 28 healthy adults (no demographic information given; TBI)

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(Flansbjer et al, 2005; n = 50; mean age = 58 (6.4) years; mean time since stroke onset = 15 (5) months; Swedish sample, Chronic SCI)

(Tilson, 2010; n = 283; mean age = 63.5 (12.5) years; assessed at approximately day 20 and day 60 post stroke, 14m walk with middle 10 m timed with or without assistance, Acute Stroke)

Tyson, S. and Connell, L. (2009). "The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: a systematic review." Clin Rehabil 23(11): 1018-1033. Find it on PubMed

Scivoletto, G., Tamburella, F., et al. (2011). "Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients." Spinal Cord 49(6): 736-740. Find it on PubMed

We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.

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van Loo, M. A., Moseley, A. M., et al. (2004). "Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study." Brain Inj 18(10): 1041-1048. Find it on PubMed

van Hedel, H. J., Wirz, M., et al. (2008). "Standardized assessment of walking capacity after spinal cord injury: the European network approach." Neurol Res 30(1): 61-73. Find it on PubMed

Moseley, A. M., Lanzarone, S., et al. (2004). "Ecological validity of walking speed assessment after traumatic brain injury: a pilot study." J Head Trauma Rehabil 19(4): 341-348. Find it on PubMed

Bohannon, R. W. (1997). "Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants." Age Ageing 26(1): 15-19. Find it on PubMed

Lin, J. H., Hsu, M. J., et al. (2010). "Psychometric comparisons of 3 functional ambulation measures for patients with stroke." Stroke 41(9): 2021-2025. Find it on PubMed

Bowden, M. G. and Behrman, A. L. (2007). "Step Activity Monitor: accuracy and test-retest reliability in persons with incomplete spinal cord injury." J Rehabil Res Dev 44(3): 355-362. Find it on PubMed

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Lemay, J. F. and Nadeau, S. (2010). "Standing balance assessment in ASIA D paraplegic and tetraplegic participants: concurrent validity of the Berg Balance Scale." Spinal Cord 48(3): 245-250. Find it on PubMed

Tilson, J. K., Sullivan, K. J., et al. (2010). "Meaningful gait speed improvement during the first 60 days poststroke: minimal clinically important difference." Phys Ther 90(2): 196-208. Find it on PubMed

(Jackson et al, 2008; n = 54 expert raters asked to assess each measure in three categories: valid or useful, useful but requires validation or changes/improvements, not useful or valid for research in SCI, SCI)

(Severinsen et al, 2011, n = 48, participants aged 68 (9) years, with reduced muscle strength and walking capacity due to an ischemic stroke 18 (6) prior to recruitment, performed 3 times, using the mean value in further analyses, Stroke)

Burns, A. S., Delparte, J. J., et al. (2011). "The reproducibility and convergent validity of the walking index for spinal cord injury (WISCI) in chronic spinal cord injury." Neurorehabil Neural Repair 25(2): 149-157. Find it on PubMed

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(Parera et al, 2006; n = 100 older adults with mild to moderate mobility limitations in a strength training trial; mean age = 77.6 (7.6) years; two-armed randomized controlled clinical trial of a 3-month home-based strength training intervention; data from baseline and 3-month intervention assessments, Geriatrics)

Perera, S., Mody, S., et al. (2006). "Meaningful change and responsiveness in common physical performance measures in older adults." Journal of the American Geriatrics Society 54(5): 743-749. Find it on PubMed