The Cone Evasion Walk test: Reliability and validity in acute stroke

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Assessing mobility and fall risk in acute stroke patients is crucial for effective rehabilitation.
• Existing tests may not fully capture the complexities of obstacle negotiation during gait.
• A reliable and valid measure is needed to evaluate the ability to evade obstacles.

Purpose of the Study:

• To determine the reliability and validity of the Cone Evasion Walk (CEW) test.
• To assess the CEW test's ability to predict falls in individuals with acute stroke.

Main Methods:

• The CEW test's reliability was assessed using video recordings and multiple physiotherapist ratings.
• Construct validity was examined by correlating CEW scores with established tests like FAC, TUG, TUG-cog, MoCA-S7, and SCT.
• Predictive validity was evaluated by assessing the relationship between CEW performance and falls over a six-month period.

Main Results:

• The CEW test demonstrated high intrarater and interrater reliability (ICC 0.88-0.98).
• Significant correlations were found between CEW and FAC, TUG, MoCA-S7, and SCT, supporting its validity.
• Touching more cones (4-8) significantly increased the risk of falls (HR 2.11).

Conclusions:

• The Cone Evasion Walk (CEW) test is a reliable and valid tool for assessing obstacle evasion in acute stroke.
• The CEW test effectively predicts fall risk in this population.
• This test can aid in tailoring rehabilitation strategies for stroke survivors.