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Relationship between walk tests and parental reports of walking abilities in children with cerebral palsy
Jimmy Chong1, Anna H Mackey, Elizabeth Broadbent
1Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.
Insights
Parental reports of walking ability in children with cerebral palsy (CP) align with clinic-based 1-minute walk tests (1MWT) and 6-minute walk tests (6MWT), validating these measures. However, parental perceptions show greater variability than test results, especially in higher functioning children.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Movement Science
Background:
- Assessing walking ability in children with cerebral palsy (CP) is crucial for monitoring function and guiding interventions.
- Clinic-based walk tests and parental reports are commonly used but their correlation requires further investigation.
Purpose of the Study:
- To evaluate the association between two clinic-based walking tests, the 1-minute walk test (1MWT) and the 6-minute walk test (6MWT), and parental reports of usual walking performance using the ABILOCO-Kids questionnaire in children with CP.
Main Methods:
- An observational study was conducted in tertiary outpatient clinics.
- Sixty children and youth with CP (GMFCS levels I-IV, mean age 11.2 years) participated.
- Data collected included the ABILOCO-Kids questionnaire, 1MWT, and 6MWT.
Main Results:
- ABILOCO-Kids scores showed significant correlations with both 1MWT (ρ=.70) and 6MWT (ρ=.70) (P<.01).
- The strength of this relationship varied by Gross Motor Function Classification System (GMFCS) level.
- The strongest prediction of variance was observed at GMFCS level II, while the weakest was at GMFCS level I.
Conclusions:
- Parental perceptions of community walking ability correlate with 1MWT and 6MWT results in ambulatory children with CP, supporting the convergent validity of these tests.
- Parental reports indicate a broader spectrum of walking abilities than reflected by walk tests, particularly for high-functioning children (GMFCS I).
Objectives:
To test the strength of association between 2 clinic-based measures of walking ability, the 1-minute walk test (1MWT) and the six-minute walk test (6MWT), and the parental report of usual walking performance, measured by the ABILOCO-Kids logit score, in children with cerebral palsy (CP).
Design:
Observational study.
Setting:
Tertiary level outpatient clinics.
Participants:
Children and youth with CP (N=60; 32 boys, 28 girls; mean age, 11.2y [range, 5-18y]), Gross Motor Function Classification System (GMFCS) level I to IV.
Interventions:
Not applicable.
Main Outcome Measures:
The 10-item ABILOCO-Kids questionnaire, the 1MWT, and the 6MWT.
Results:
ABILOCO-Kids logit scores were significantly correlated with the 1MWT (ρ=.70, P<.01) and the 6MWT (ρ=.70, P<.01) but not with age or sex. Linear models revealed a possibly significant difference in the strength of the relationship of the ABILOCO-Kids logit score with walking distance, depending on GMFCS level (P=.06 1MWT; P=.14 6MWT). The strongest relationship was observed at GMFCS level II, where ABILOCO-Kids score predicted 33% of variance in 1MWT (P=.003) and 31% of 6MWT (P=.003). The weakest relationship was at GMFCS level I, where ABILOCO-Kids score predicted only 5% of the variance in 1MWT (P=.33) and 16% of the variance in 6MWT (P=.08).
Conclusions:
Parental perceptions of their child's walking ability in the community correlate with clinic-based walking tests in ambulatory children with CP, providing evidence of convergent validity for the 1MWT and 6MWT. However, parents report a much wider range of walking abilities in children who function at a high level (GMFCS I) than is reflected by their walk test results.
