Related Experiment Video
Updated: Jul 2, 2025
The Ladder Rung Walking Task: A Scoring System and its Practical Application.
Published on: June 12, 2009
Is the Walking Adaptability Ladder test for Kids (WAL-K) reliable and valid in ambulatory children with Cerebral
Rosanne Kuijpers1,2, Brenda E Groen1,2, Ellen Smulders2,3
1Sint Maartenskliniek Research, Nijmegen, The Netherlands.
Insights
The Walking Adaptability Ladder test for Kids (WAL-K) is a reliable and valid tool for assessing walking adaptability in children with Cerebral Palsy (CP). This test helps evaluate mobility in young individuals with CP.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Science
Background:
- Walking adaptability is crucial for children's daily life participation.
- Cerebral Palsy (CP) often impacts motor skills, including walking.
- Assessing walking adaptability in children with CP requires reliable and valid tools.
Purpose of the Study:
- To evaluate the reliability and validity of the Walking Adaptability Ladder test for Kids (WAL-K).
- To assess walking adaptability in ambulatory children aged 6-12 years with Cerebral Palsy (CP).
Main Methods:
- Thirty-six children with CP (GMFCS levels I and II) underwent the WAL-K test.
- Intra- and inter-rater reliability were assessed using Intraclass Correlation Coefficients (ICCs).
- Construct validity was examined by comparing scores with typically developing children and the 10x5m Sprint Test (10x5mST).
Main Results:
- The WAL-K demonstrated excellent reliability (ICCs 0.997-1.000).
- CP children scored significantly worse on the WAL-K than typically developing children (p < 0.001).
- WAL-K scores correlated strongly with the 10x5mST (r = .89 single, r = .84 double).
Conclusions:
- The WAL-K is a promising, reliable, and valid instrument for assessing walking adaptability in children with CP.
- The test is easy to use and suitable for this population.
- Further research is needed to evaluate the test's responsiveness to change.
Purpose:
Walking adaptability is essential for children to participate in daily life. We studied whether the Walking Adaptability Ladder test for Kids (WAL-K) is reliable and valid for assessing walking adaptability in 6-12 year old ambulatory children with Cerebral Palsy (CP).
Materials And Methods:
Thirty-six children with CP (26 GMFCS-level I, 10 GMFCS-level II) completed the single and double run of the WAL-K. Intra- and inter-rater reliability were determined by Intraclass Correlation Coefficients (ICCs). Construct validity was determined by comparing WAL-K scores between 122 typically developing (TD) and CP children taking age into account, comparing WAL-K scores between CP children in GMFCS-levels I and II, and correlating WAL-K scores with scores of the 10 times 5 m Sprint Test (10 × 5mST).
Results:
ICCs for reliability varied between 0.997 and 1.000. WAL-K scores were significantly higher (i.e., worse) in CP children compared to TD children (p < 0.001), and in children in GMFCS-level II compared to GMFCS-level I (p = 0.001). Significant positive correlations were found between the WAL-K and 10 × 5 mST (single run r = .89, double run r = .84).
Conclusions:
The WAL-K shows to be a promising reliable, valid, and easy-to-use tool for assessing walking adaptability in children with CP. Responsiveness to change has yet to be evaluated.
