Bath Assessment of Walking Inventory

Original Editor - Ajay Upadhyay

Top Contributors - Rachael Lowe, Ajay Upadhyay, Evan Thomas and Claire Knott

Objective

Chronic pain has widespread detrimental effects on normal functioning. Patients commonly complain of unwelcome changes in their capacity, ability and quality of movement. Although the measurement of function is a frequent component of clinical assessment, instruments often rely on patient self-report of remembered global function on specific tasks of physical capacity or are global measures of bodily awareness. To date walking assessment has relied on a laboratory setting. No unobtrusive, clinically easy to use instruments exist to measure the quality of walking when in pain. An abnormal gait is not of itself a clinically significant problem. Indeed many patients report a lack of awareness of how they walk. Walking is often only a means to achieve a goal. However, the social context of pain behaviour and the effect of pain behaviour on observers are often clinically important. Judgements about pain are known to be based on verbal and facial behaviour. we do not know what the critical factors are which, when therapeutically manipulated, can lead to sustained improvements in walking quality. Establishing instruments to measure the quality of walking is a critical first step in enabling future research into the ‘biopsychosocial’ influences on walking quality. Understanding the complexity of walking is essential in clinical formulation and treatment planning; achieving a reliable measure of walking quality will also allow for the further investigation of pain-related function. The primary objective is to develop an assessment tool designed specifically to assess the quality of walking in adults with chronic pain for use in clinical and research settings.

Intended Population

Adults over 17 years of age, reporting pain of at least six months in duration, with intact limbs and without any structural impairment that restricted range or pattern of movement.

Document

Measures used were:

  • Two minute timed walk test (TMTWT)
  • One minute sit to stand (STS)
  • Sickness impact profile (SIP)

Evidence

Reliability

Clarke and Eccleston (2009)[1]

Demonstrates good internal consistency (Cronbach 0.71) and adequate intra- (Kappa 0.61–0.98) and inter-rater reliability (Kappa 0.61–0.98).

Validity

Clarke and Eccleston (2009)[1]

Validity was established in comparison with well-used measures of functioning.

Responsiveness

Further independent study is required to develop this instrument.

Resources

Jane E. Clarke and Christopher Eccleston (2009). Assessing the quality of walking in adults with chronic pain: The development and preliminary psychometric evaluation of the Bath Assessment of Walking Inventory, European Journal of Pain, 13(3), 305-311

References

  1. 1.0 1.1 Jane E. Clarke and Christopher Eccleston (2009). Assessing the quality of walking in adults with chronic pain: The development and preliminary psychometric evaluation of the Bath Assessment of Walking Inventory, European Journal of Pain, 13(3), 305-311