Walking Adaptability after a Stroke and Its Assessment in Clinical Settings

Table 3

Domains of walking adaptability captured by performance-based clinical assessments of walking function.

Clinical assessment items		Domains of walking adaptability*
		ON	TM	CT	TR	AM	PT	MT	PL	TF
DGI
2	Change speed		TM
3	Horizontal head turns						PT
4	Vertical head turns						PT
5	Gait and pivot turn						PT
6	Step over obstacle	ON
7	Step around obstacle									TF
8	Stairs				TR
FGA
2	Change speed		TM
3	Horizontalhead turns						PT
4	Verticalhead turns						PT
5	Gait andpivot turn						PT
6	Step over obstacle	ON
7	Narrow BOS						PT
9	Ambulate backwards						PT
10	Stairs				TR
mEFAP
2	Carpet				TR
3	Up and go						PT
4	Step over and around obstacles	ON								TF
5	Stairs				TR
SCI-FAP
1	Carpet				TR
2	Up and go						PT
3	Obstacles	ON
4	Stairs				TR
5	Carry								PL
6	Step Up	ON
7	Door						PT	MT
Hi-MAT
2	Walk backwards		TM				PT
3	Walk on toes		TM				PT
4	Walk over obstacle	ON	TM
	Stairs/dependant				TR
	Stairs/independent				TR
CB&M
2	Tandem walk						PT
6	Crouch and walk						PT	MT
8	Walk and look						PT
10	Forward to Backward walk		TM				PT
11	Walk, look, and carry						PT	MT
12	Descending stairs				TR
SOMAI
	Cushion 1-NV				TR
	Cushion 2-NV				TR
	Cushion 1-FV				TR	AM
	Cushion 2-FV				TR	AM
WIT
2	4 m walk fast		TM
3	4 m BOS 25 cm		TM				PT
4	4 m BOS 15 cm		TM				PT
5	7 m walk fast		TM
6	7 m walk long steps						PT
7	7 m fast walk obstacles	ON	TM
8	7 m fast walk obstacles dim light	ON	TM			AM
9	7 m usual walk carry package							MT
10	7 m usual pace naming objects			CT
11	7 m usual pace pick up objects						PT	MT
12	400 m fast walk		TM
13	60 m fast walk weighted jacket		TM						PL
SWOC
1	Tandem walk						PT
2	Balance ladder with foam	ON			TR
3	Ramp and stairs				TR
4	Pick up empty box						PT	MT
5	Miniblind						PT
6	Step over a block				TR
OC
1	Door opening						PT	MT
2	Turf				TR
3	Objects	ON
4	Carpet				TR
5	Low steps				TR
6	Pine Bark				TR
7	Cones									TF
8	Sand				TR
9	Chair						PT
10	Steep steps				TR
11	Upramp				TR
12	Downramp				TR
MTT
1	Stand Up, walk, turn, and sit down						PT
2	Item 1 + answer questions			CT			PT
3	Item 1 + avoid obstacles	ON					PT			TF
4	Item 1 + carry an empty tray						PT	MT
5	Item 1 + carry tray of 2 eggs, 1 rolling egg						PT	MT
6	Item 1 + slippery shoes				TR		PT
7	Item 1 + tip the floor halfway						PT
8	Item 1 + wear sunglasses in dim light					AM	PT

Items represented in bold are redundant across assessments.
Abbreviations: DGI, dynamic gait index; FGA, functional gait assessment; mEFAP, modified Emory functional ambulation profile; SCI-FAP, spinal cord injury functional ambulation profile; Hi-MAT, high-level mobility assessment test; CB&M, community balance and mobility scale; SOMAI, sensory-oriented mobility assessment instrument; WIT, walking InCHIANTI toolkit; SWOC, standardized walking obstacle course developed by Rubenstein and colleagues; obstacle course, obstacle course developed by Means and colleagues; MTT, multiple task test; ON, obstacle negotiation; TM, temporal demands; CT, cognitive dual-tasking; TR, terrain demands; AM, ambient demands; PT, postural transitions demands; MT, motor dual-tasking; PL, physical load; TF, maneuvering in traffic; BOS, base of support; NV, normal vision; FV, focal vision.
*The domains for walking adaptability have been adapted from earlier work by Patla and Shumway-Cook [15].