Assessment of test-retest reliability and internal consistency of the Wisconsin Gait Scale in hemiparetic post-stroke patients
Languages of publication
Introduction A proper assessment of gait pattern is a significant aspect in planning the process of teaching gait in hemiparetic post-stroke patients. The Wisconsin Gait Scale (WGS) is an observational tool for assessing post-stroke patients’ gait. Study aim. The aim of the study was to assess test-retest reliability and internal consistency of the WGS and examine correlations between gait assessment made with the WGS and gait speed, Brunnström scale, Ashworth’s scale and the Barthel Index. Material and methods The research included 36 post-stroke patients. The patients’ gait was assessed with the use of the Wisconsin Gait Scale, gait speed with the use of walk test, the level of motor control in a paretic lower limb – according to Brunnström recovery stages, muscle tone in a paretic lower limb – according to modified Ashworth’s scale and functional independence was assessed using the Barthel Index. Gait was assessed with the use of the WGS twice, with a 7-day interval, by three experienced physiotherapists. Results The analysis of internal consistency of the WGS revealed that the Cronbach’s α coefficient was high in the case of all the three raters and ranged from 0.85 to 0.88. It was noted that the coefficient of variation for all the comparisons was below 10%. When assessing the repeatability of the results, it was revealed that correlations between both measurements made by particular raters were very strong and highly significant. The WGS results significantly correlated with Brunnström scale, Ashworth’s scale and gait speed. Conclusions It was concluded that the WGS has a high internal consistency and test-retest reliability. Also, significant correlations were found between gait assessment made with the use of the WGS and gait speed, level of motor control and muscle tone of a paretic lower limb. The WGS constitutes a promising tool for a qualitative, observational analysis of gait in post-stroke patients and allows for proper planning, monitoring and assessing rehabilitation results.
- Mun BM, Kim TH, Lee JH, Lim JY, Seo DK, Lee DJ. Comparison of Gait Aspects According to FES Stimulation Position Applied to Stroke Patients. J Phys Ther Sci. 2014;26(4):563-6.
- Sakuma K, Ohata K, Izumi K, Shiotsuka Y, Yasui T, Ibuki S, et al. Relation between abnormal synergy and gait in patients after stroke. J Neuroeng 2014; 25(11):141.
- Belda-Lois JM, Mena-del Horno S, Bermejo-Bosch I, Moreno JC, Pons JL, Farina D, et al. Rehabilitation of gait after stroke: a review towards a top-down. J Neuroeng Rehabil 2011;13(8):66.
- Qi Y, Soh CB, Gunawan E, Low KS, Thomas R. Estimation of spatial-temporal gait parameters using a low-cost ultrasonic motion analysis system. Sensors (Basel) 2014;14(8):15434-57.
- Perry J, Garret M, Gronley JK, Mulroy SJ. Classification of walking handicap in the stroke population. Stroke 1995;26:982-989.
- Patterson KK, Nadkarni, NK, Black SE, McIlroy WE. Temporal gait symmetry and velocity differ in their relationship to age. Gait Posture 2012;35(4):590–94.
- Yaliman A, Kesiktas N, Ozkaya M, Eskiyurt N, Erkan O, Yilmaz E. Evaluation of intrarater and interrater reliability of the Wisconsin Gait Scale with using the video taped stroke patients in a Turkish sample. NeuroRehabilitation 2014;34(2):253-8.
- Mudge S, Stott N. Outcome measures to assess walking ability following stroke: a systematic review of the literature. Physiotherapy 2007;93:189–200.
- Tenore N, Fortugno F, Viola F, Galli M, Giaquinto S. Gait Analysis as a Reliable Tool for Rehabilitation of Chronic Hemiplegic Patients. Clin Exp Hypertens 2006;28(3-4):349-55.
- Geroin C, Mazzoleni S, Smania N, Gandolfi M, Bonaiuti D, Gasperini G, et al; Italian Robotic Neurorehabilitation Research Group. Systematic review of outcome measures of walking training using electromechanical and robotic devices in patients with stroke. J Rehabil Med 2013;45:987–96.
- Drużbicki M, Szymczyk D, Snela S, Dudek J, Chuchla M. Obiektywne, ilościowe metody analizy chodu w praktyce klinicznej. Prz Med Uniw Rzesz 2009;4:356–62.
- Gor-García-Fogeda MD, Cano de la Cuerda R, Carratalá Tejada M, Alguacil-Diego IM, Molina-Rueda F. Observational Gait Assessments in People With Neurological Disorders: A Systematic Review. Arch Phys Med Rehabil 2016;97(1):131-40.
- Pizzi A, Carlucci, G, Falsini, C, Lunghi F, Verdesca S, Grippo A. Gait in hemiplegia: Evaluation of clinical features with the Wisconsin Gait Scale. J Rehabil Med 2007;39(2):170-74.
- Wren TA, Gorton GE, Ounpuu S, Tucker CA. Efficacy of clinical gait analysis: A systematic review. Gait & Posture 2011;34(2):149-53.
- Turani N, Kemiksizog A, Karatas M. Assessment of hemiplegic gait using the Wisconsin Gait Scale. Scand J Caring Sci 2004;18:103–08.
- Rodriquez AA, Black PO, Kile KA, Sherman J, Stellberg B, McCormnick J, et al. Gait training efficacy using a home-based practice model in chronic hemiplegia. Arch Phys Med Rehabil 1996;77:801–05.
- Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing 1997;26(1):15-19.
- Brunnström S. Motor testing procedures in hemiplegia. J Am Phys Ther Assoc 1966;46,4:357-375.
- Bohannon R, Smith M. Interrater reliability of a modified Ashworth scale of muscle spasticity Physical Therapy 1987;67(2):206.
- Barthel DW, Mahoney FJ. Functional evaluation: the Barthel index. Maryland State Med J 1965;14:61-65.
- Drużbicki M, Przysada G, Kołodziej K, Rykała J, Podgórska J. Ocena chodu chorych z niedowładem połowiczym po udarze mózgu z wykorzystaniem Wisconsin Gait Scale – doniesienie wstępne. Prz Med Uniw Rzesz 2010;2:152–59.
- Bland JM, Altman DG. Statistical methods for assesing agreement between two methods of clinical measurement. Lancet 1986;1(8476):307-10.
- Cronbach LJ. Coefﬁcient alpha and the internal structure of tests. Psychometrika, 1951;16:297-334.
- Lu X, Hu N, Deng S, Li J, Qi S, Bi S. The reliability, validity and correlation of two observational gait scales assessed by video tape for Chinese subjects with hemiplegia. J Phys Ther Sci 2015;27(12):3717-21.
Publication order reference