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Reliability and Concurrent Validity of the Narrow Path Walking Test in Persons With Multiple Sclerosis
1Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (U.R., I.M.); and Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel (U.R.).
Journal of Neurologic Physical Therapy : JNPT
|December 16, 2016
Summary
The Narrow Path Walking Test (NPWT) shows high reliability for assessing gait instability in people with multiple sclerosis (PwMS). Number of Step Errors and Trial Velocity are particularly reliable and valid measures for dynamic balance assessment.
Area of Science:
- Neurology
- Rehabilitation Science
- Movement Science
Background:
- Gait instability affects approximately 90% of people with multiple sclerosis (PwMS), leading to a 50% fall rate.
- There is a critical need for reliable and clinically feasible methods to assess gait instability in PwMS.
Purpose of the Study:
- To investigate the reliability and validity of the Narrow Path Walking Test (NPWT) for assessing gait instability.
- To evaluate NPWT performance under both single-task (ST) and dual-task (DT) conditions in PwMS.
Main Methods:
- Thirty PwMS completed the NPWT twice, one week apart, with measurements including Number of Steps, Trial Time, Trial Velocity, Step Length, Number of Step Errors, Number of Cognitive Task Errors, and Number of Balance Losses.
- Relative reliability was assessed using Intraclass Correlation Coefficients (ICC2,1), and absolute reliability was quantified using standard error of measurement (SEM) and smallest real difference (SRD).
- Concurrent validity was determined by correlating NPWT parameters with established measures: Functional Reach Test, Four Square Step Test (FSST), 12-item Multiple Sclerosis Walking Scale (MSWS-12), and 2 Minute Walking Test (2MWT).
Main Results:
- Most NPWT parameters demonstrated high relative reliability, with ICCs ranging from 0.46-0.94 (ST) and 0.55-0.95 (DT).
- Number of Step Errors (ICC = 0.94 ST, 0.93 DT) and Trial Velocity (ICC = 0.83 ST, 0.86 DT) exhibited the highest relative reliability.
- Number of Step Errors showed high absolute reliability (SEM % = 19.53% ST, 18.14% DT), while Trial Velocity had low absolute reliability (SEM % = 6.88% ST, 7.29% DT). Significant correlations were observed between Number of Step Errors and Trial Velocity with FSST, MSWS-12, and 2MWT.
Conclusions:
- The Number of Step Errors and Trial Velocity are highly reliable parameters for the NPWT in people with multiple sclerosis.
- The Number of Step Errors emerged as the most valid parameter for assessing dynamic balance in PwMS during the NPWT, based on its correlations with other gait instability measures.
