10 Metre Walk Test

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Objective[edit | edit source]

The 10 Metre Walk Test is a performance measure used to assess walking or gait speed in meters per second over a short distance[1]. It can be employed to determine functional mobility, gait, and vestibular function[2].

Normative Values[edit | edit source]

Age

(Men and Women)

Average Walking Speed

(m/s)

20-29 1.36-1.34 m/s
30-39 1.43-1.34 m/s
40-49 1.43-1.39 m/s
50-59 1.43-1.31 m/s
60-69 1.34-1.24 m/s
70-79 1.26-1.13 m/s
80-990 0.97-0.94 m/s


Intended Population[edit | edit source]

Preschool children (2-5 years), children (6-12 years), adolescents (13-17 years), adults (18-64 years), elderly adults (65+) with a range of diagnoses including:

Method of Use[edit | edit source]

Equipment Required

  • Walkway of 10m with additional 2m at both ends, marked with tape, for acceleration & deceleration (14 m total). The 14-metre walkway is marked 0-, 2-, 12-, and 14-metre points. There are different standardizations for the conducting of the 10MWT, for example, measuring over different distances (10 or 6 m) and the inclusion or exclusion of an acceleration distance, i.e., dynamic vs. static start.[3][4]
  • 2 chairs
  • stopwatch/timer
  • usual walking aid

Time Required

5 mins to administer & score

Scoring

  • The total time taken to ambulate 10 meters is recorded
    • Timing starts when the toes pass the 2-meter mark
    • Timing stops when the toes pass the 12-meter mark
  • The 10m is then divided by the total time taken (in seconds) to completed
  • The total time is recorded in m/s


Instructions

  • The participant is instructed to walk a total of 14 meters in each walk, including 2-meter initiation and termination phases. Their walking pace was assessed across the 10-meter distance between these two points. The middle ten meters of a fourteen-meter walkway were timed[5][4]
  • Assistive devices may be used, but must be kept consistent and documented for each test
  • Start timing when the toes pass the 2-meter mark
  • Stop timing when the toes pass the 12-metre mark
  • Can be tested at either preferred walking speed or maximum walking speed (ensure to document which was tested)
  • The therapist describes the task to the client that 10 metre walk test will measures patient's walking speed over ten metres. Ask patient to walk at a comfortable pace and/or at a faster pace.
  • Perform three trials and calculate the average of three trials
  • Walk at least a half step behind the patient. During the test, do not walk in front of or directly beside the patient, as this may “pace” the patient and influence the speed and distance they walk. [6]


[7]



Evidence[edit | edit source]

Reliability[edit | edit source]

The 10-meter walk test has demonstrated excellent reliability in many conditions including healthy adults, children with neuromuscular disease, Parkinson's disease, hip fracture, Spinal cord injury, Stroke, and Traumatic brain injury.

Test-Retest Reliability[edit | edit source]

Children with Neuromuscular Disease: (n = 29; mean age = 11.5 (3.5) years (6-16), Children with Neuromuscular Disease)

  • Excellent test-retest reliability (ICC = 0.91) [8]


Healthy Adults:

  • Excellent test-retest reliability for comfortable gait speed (r = 0.75 - 0.90) [9]
  • Excellent test-retest reliability for comfortable and fastest gait speeds (ICC = 0.93 - 0.91) [10]

Hip Fracture:

  • Excellent test-retest reliability (ICC = 0.823 with 95% CI = 0.565 to 0.934) [11]

Parkinson’s Disease or Parkinsonism:

  • Excellent test-retest reliability for comfortable gait speed (ICC = 0.96)
  • Excellent test-retest reliability for maximum gait speed (ICC = 0.97) [12]

SCI:

  • Excellent test-retest reliability (ICC = 0.97) [13]
  • Excellent test-retest reliability (r = 0.983) [14]

Stroke: (n = 25; mean age = 72 years; stroke onset = 2 to 6 years, Chronic Stroke)
Test-retest assessed three times within a single session:

  • Excellent test-retest reliability (ICC = 0.95 to 0.99) [15]
  • Excellent reliability for comfortable (ICC = 0.94) and fast (ICC = 0.97) gait speeds [16]

TBI (Traumatic brain injury):

  • Excellent between day reliability at comfortable (ICC = 0.95) and fast speeds (ICC = 0.96) [17]
  • Excellent test-retest reliability (r = 0.97 - 0.99) [9]


TKA/THA

  • Excellent for fast-paced 10mWT (TKA: ICC=0.82-0.95 ; THA: ICC=0.96 ).[18]

Interrater/Intrarater Reliability[edit | edit source]

Healthy Adults: (n = 28 healthy adults; mean age = 56.43 (+/- 13.82) years)

  • Excellent interrater reliability (ICC = 0.980) [19]

SCI ( Spinal cord injury):

  • Excellent intrarater reliability (r = 0.983, p < 0.001)
  • Excellent interrater reliability (r = 0.974, p < 0.001)
  • Bland-Altman plots indicate reliability as being excellent when completed in under 40 seconds, but reliability decreases with marginal walkers requiring > 40 seconds to complete [20]
  • Scivoletto et al 2011 (n = 37; median age = 58.5 (range 19 - 77) years; median time from onset = 24 (range 6 - 109) months; AIS D = 35, C = 2; Median WISCI = 16) utilized 2 methods in chronic SCI (measured 10 m with a static start and measured middle 10 m of 14 m walkway to include acceleration and deceleration), both showing:
    • Excellent interrater reliability (ICC > 0.95)
    • Excellent intrarater reliability (ICC > 0.98) [21]

Stroke: (Wolf et al, 1999; n = 28 with history of stroke; mean age = 56.04 (12.80) years; mean time since lesion = 13.59 (12.30) months, Chronic Stroke)

  • Excellent intrarater reliability; ICC = 0.87 to 0.88 [15]
  • Excellent interrater reliability; (ICC = 0.998) [19]

TBI (Traumatic brain injury): (Tyson & Connell, 2009; review of seventeen measures; n = 12 mobile TBI patients, TBI)

  • Excellent interrater reliability (ICC = 0.99) [22]

Knee/Hip OA

Good (ICC=0.88) for fast-paced 10mWT.[23]

Validity[edit | edit source]

Criterion Validity[edit | edit source]

Multiple Sclerosis: (Paltamaa et al, 2007; n = 120; mean age = 45.0 (10.8) years; mean duration since symptom onset 12.3 (8.8) years, MS)
Predictive Validity [24]:

  • Excellent correlation with dependence in self-care (r = 0.60 - 0.87) at comfortable speed
  • Adequate to Excellent correlation with dependence in mobility (r = 0.34 - 0.74) at comfortable speed
  • Adequate to excellent correlation with dependence in domestic life (r = 0.34 - 0.81) at comfortable speed


Stroke: (Tyson & Connell, 2009; n = 40, review article of 17 measures, Stroke)
Predictive Validity [22]:

  • Excellent correlation with dependence in instrumental activities of daily living (r = 0.76)
  • Excellent correlation with Barthel Index (r = 0.78


TKA/THA/Hip or Knee OA:

No evidence found comparing to instrumented/accelerometry-determined walking speed for knee/hip OA & TKA/THA.

Construct Validity[edit | edit source]

Healthy Adults:

  • Poor correlation with BBT (r = 0.052)
  • Adequate correlation with FRT (r = 0.307) [19]

Hip Fracture:

  • Excellent correlation with 6MWT (correlation coefficient = 0.82)
  • Adequate correlation with LE strength (r = 0.51)
  • Adequate correlation with LE power (r = 0.58)
  • Poor correlation with hip pain (r = -0.23)
  • Poor correlation with bodily pain (r = 0.30)
  • Poor correlation with vitality (r = 0.26)
  • Adequate correlation with physical role (r = 0.54)
  • Adequate correlation with social role (r = 0.42) [25]

TKA:

  • Poor correlation with Global Rating of Change Function, Global Rating of Change Pain & WOMAC at 6-wks & 12-wks post-op (r=-0.16 to 0.22).[26]
  • Bilateral TKA: Moderate correlation with Fall Efficacy Scale-International (r=0.62) & Berg Balance Scale at 6-mos (r=-0.74).[27]

Convergent Validity[edit | edit source]

SCI (Spinal cord injury):

  • Excellent correlation between the TUG and 10MWT (r = 0.89, n = 70)
  • Excellent correlation between 10MWT and 6MWT (ρ = -0.95, n = 62)
  • Subgroup comparisons of WISCI II and 10MWT
  • Excellent correlation between WISCI II and 10MWT when testing individuals with WISCI II scores 11 - 20 (p = -0.68, n = 47)
  • Poor correlation between the WISCI II and 10MWT when testing individuals with WISCI II scores 0 - 10 (r = -0.24, n = 20)
  • Adequate but not significant correlation between WISCI II (0-8,10,11,14,17), dependent walkers (r = -0.35, n = 15)
  • Adequate correlation between WISCI II (9,12,13,15,16,18-20) independent walkers (r = -0.48, n = 43)
  • Overall, improved validity in individuals who are less impaired, higher walking ability, and do not require assistance [28]


Stroke:

  • Excellent correlation between comfortable gait speed and TUG (ICC = -0.84), FGS (ICC = 0.92), Stair climbing ascend (SCas) (ICC = -0.81), Stair climbing descend (SCde) (ICC = -0.82), 6MWT (ICC = 0.89)
  • Excellent correlation between fast gait speed and TUG (ICC = -0.91), CGS (ICC = 0.88), SCas (ICC = -0.84), SCde (ICC = -0.87) and 6MWT (ICC = 0.95) [16]

Concurrent[edit | edit source]

TKA/THA &Knee/Hip OA

  • No evidence found comparing to 4m test for TKA/THA & knee/hip OA.
  • TKA: Poor correlation with WOMAC (r=0.21 to 0.27) & poor-moderate correlation with 30sCST (r=-0.34 to -0.57) at initial, 6-wks & 12-wks post-op. [26]
  • THA: No evidence found
  • Healthy older adults: Poor concurrent validity with 4mWT thus 4mWT & 10mWT should not be used interchangeably. [29]

Responsiveness[edit | edit source]

Geriatrics:

  • Small meaningful change = 0.05 m/s
  • Substantial meaningful change = 0.10 m/s [30]


SCI (Spinal cord injury):

  • Smallest real difference = 0.13 m/s
  • Mean change between 1 and 3 months post-injury, effect size = 0.92
  • Mean change between 3 and 6 months post-injury, effect size = 0.47 [14]


Stroke:

  • Small meaningful change = 0.05 m/s
  • Substantial meaningful change = 0.10 m/s [30]

TKA:

  • Small ES up to 6-wks post-op (0.48), moderate at 6-12 wks (0.74) & moderate at 12-wks (0.71). Pooling test distances 3.8-10m, self-paced walking speed increased from 0.96 m/s pre-op to 1.16 m/s 6–12-mos post-op with plateau or slight decline after 12-mos.[31]
  • THA: Over varied test distances, meta-analysis found small to large ES in self-paced walking speed from pre-op to 6-wks post-op (SMD=0.32) & pre- to 12-mos post-op (SMD=1.28). [32]

Floor/Ceiling Effects No evidence found

References[edit | edit source]

  1. ↑ Academy of Neurologic Physical Therapy. Core Set of Outcome Measures for Adults with Neurologic Conditions. [Accessed 6 May 2022]
  2. ↑ Academy of Neurological Physical Therapy. Core Measure: 10 Meter Walk Test. [Accessed 6 May 2022]
  3. ↑ Lindholm B, Nilsson MH, Hansson O, Hagell P. The clinical significance of 10-m walk test standardizations in Parkinson’s disease. Journal of neurology. 2018 Aug;265:1829-35.
  4. ↑ 4.0 4.1 Clinical Task Instructions. Queensland Health. 10 metre Walk Test (10mWT)
  5. ↑ Nemanich ST, Duncan RP, Dibble LE, Cavanaugh JT, Ellis TD, Ford MP, Foreman KB, Earhart GM. Predictors of gait speeds and the relationship of gait speeds to falls in men and women with Parkinson disease. Parkinson’s disease. 2013;2013(1):141720.
  6. ↑ 10 Meter Walk Test (10mWT)https://neuropt.org/docs/default-source/cpgs/core-outcome-measures/core-outcome-measures-documents-july-2018/10mwt_protocol_final.pdf?sfvrsn=29cd5443
  7. ↑ Mission Gait - 10 Meter Walk Test - Setup and Instruction. Available from: https://youtu.be/jKZcQM5PGq8 [last accessed 6 May 2022]
  8. ↑ Pirpiris, M., Wilkinson, A., et al. "Walking speed in children and young adults with neuromuscular disease: comparison between two assessment methods." Journal of Pediatric Orthopaedics 2003 23(3): 302
  9. ↑ 9.0 9.1 Watson, M. J. "Refining the ten-metre walking test for use with neurologically impaired people." Physiotherapy 2002 88(7): 386-397
  10. ↑ Bohannon, R. W. "Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants." Age Ageing 1997 26(1): 15-19
  11. ↑ Hollman, J. H., Beckman, B. A., et al. "Minimum detectable change in gait velocity during acute rehabilitation following hip fracture." J Geriatr Phys There 2008 31(2): 53-56
  12. ↑ Steffen, T. and Seney, M. "Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism." Physical Therapy 2008 88(6): 733-746
  13. ↑ Bowden, M. G. and Behrman, A. L. "Step Activity Monitor: accuracy and test-retest reliability in persons with incomplete spinal cord injury." J Rehabil Res Dev 2007 44(3): 355-362
  14. ↑ 14.0 14.1 Lam, T., Noonan, V., et al. "A systematic review of functional ambulation outcome measures in spinal cord injury." Spinal Cord 2007 46(4): 246-254
  15. ↑ 15.0 15.1 Collen, F., Wade, D., et al. "Mobility after stroke: reliability of measures of impairment and disability." Disability and Rehabilitation 1990 12(1): 6-9
  16. ↑ 16.0 16.1 Flansbjer, U. B., Holmback, A. M., et al. "Reliability of gait performance tests in men and women with hemiparesis after stroke." J Rehabil Med 2005 37(2): 75-82
  17. ↑ van Loo, M. A., Moseley, A. M., et al. "Test-re-test reliability of walking speed, step length and step width measurement after traumatic brain injury: a pilot study." Brain Inj 2004 18(10): 1041-1048
  18. ↑ Unver B, Baris RH, Yuksel E, Cekmece S, Kalkan S, Karatosun V. Reliability of 4-meter and 10-meter walk tests after lower extremity surgery. Disability and rehabilitation. 2017 Dec 4;39(25):2572-6.
  19. ↑ 19.0 19.1 19.2 Wolf, S. L., Catlin, P. A., et al. "Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile." Phys There 1999 79(12): 1122-1133
  20. ↑ van Hedel, H. J., Wirz, M., et al. "Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests." Archives of Physical Medicine and Rehabilitation 2005 86(2): 190-196
  21. ↑ Scivoletto, G., Tamburella, F., et al. "Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients." Spinal Cord 2011 49(6): 736-740.
  22. ↑ 22.0 22.1 Tyson, S. and Connell, L. "The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: a systematic review." Clin Rehabil 2009 23(11): 1018-1033
  23. ↑ Dobson F, Hinman RS, Hall M, Marshall CJ, Sayer T, Anderson C, Newcomb N, Stratford PW, Bennell KL. Reliability and measurement error of the Osteoarthritis Research Society International (OARSI) recommended performance-based tests of physical function in people with hip and knee osteoarthritis. Osteoarthritis and Cartilage. 2017 Nov 1;25(11):1792-6.
  24. ↑ Paltamaa, J., Sarasoja, T., et al. "Measures of physical functioning predict self-reported performance in self-care, mobility, and domestic life in ambulatory persons with multiple sclerosis." Archives of physical medicine and rehabilitation 2007 88(12): 1649-1657
  25. ↑ Latham, N., Mehta, V., et al. "Performance-based or self-report measures of physical function: which should be used in clinical trials of hip fracture patients?" Archives of physical medicine and rehabilitation 2008 89(11): 2146-2155
  26. ↑ 26.0 26.1 Van Bussel JL. Reliability and Validity of Two Performance-Based Outcome Measures in Rehabilitation Following Total Knee Arthroplasty (Doctoral dissertation, The University of Western Ontario (Canada)).
  27. ↑ Sarac DC, Unver B, Karatosun V. Validity and reliability of performance tests as balance measures in patients with total knee arthroplasty. Knee Surgery & Related Research. 2022 Mar 10;34(1):11.
  28. ↑ van Hedel, H. J., Wirz, M., et al. "Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests." Archives of Physical Medicine and Rehabilitation 2005 86(2): 190-196
  29. ↑ Peters DM, Fritz SL, Krotish DE. Assessing the reliability and validity of a shorter walk test compared with the 10-Meter Walk Test for measurements of gait speed in healthy, older adults. Journal of geriatric physical therapy. 2013 Jan 1;36(1):24-30.
  30. ↑ 30.0 30.1 Perera, S., Mody, S., et al. "Meaningful change and responsiveness in common physical performance measures in older adults." Journal of the American Geriatrics Society 2006 54(5): 743-749
  31. ↑ Abbasi-Bafghi H, Fallah-Yakhdani HR, Meijer OG, de Vet HC, Bruijn SM, Yang LY, Knol DL, Van Royen BJ, van Dieën JH. The effects of knee arthroplasty on walking speed: a meta-analysis. BMC musculoskeletal disorders. 2012 Dec;13:1-0.
  32. ↑ Bahl JS, Nelson MJ, Taylor M, Solomon LB, Arnold JB, Thewlis D. Biomechanical changes and recovery of gait function after total hip arthroplasty for osteoarthritis: a systematic review and meta-analysis. Osteoarthritis and cartilage. 2018 Jul 1;26(7):847-63.


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