Assessment of Walking Speed and Distance in Subjects With an Incomplete Spinal Cord Injury

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Abstract
Background. The 10-meter walk test and 6-minute walk test are increasingly used to evaluate the recovery of walking in patients with incomplete spinal cord injury. So far, there is no evidence whether the application of different walking distances provides complementary information about ambulatory capacity in patients with incomplete spinal cord injury. Studies about testing preferred and maximum speeds in subjects with incomplete spinal cord injury are lacking. Objective. To determine whether the combined testing of short and long distances as well as preferred and maximum speeds provides additional information about walking capacity in subjects with incomplete spinal cord injury. Methods . Depending on the objective, the subjects with incomplete spinal cord injury and age-matched control subjects had to perform the 10-meter walk test or 6-minute walk test at preferred and/or maximum walking speed. Results. During recovery, the preferred walking speed increased but did not differ when assessed during short or long distances in 51 subjects with incomplete spinal cord injury at 1, 3, and 6 months after injury (mean and SD, 6-minute walk test: 0.37 ± 0.52, 0.87 ± 0.56, and 1.14 ± 0.52 ms —1; 10-meter walk test: 0.40 ± 0.53, 0.88 ± 0.51, and 1.12 ± 0.51 ms—1, respectively). In 18 subjects with incomplete spinal cord injury, both preferred and maximum walking speeds assessed with the 10-meter walk test predicted the walking speeds of the 6-minute walk test well. Subjects with incomplete spinal cord injury prefer to walk closer to their maximum walking speed (74% ± 10%) compared to control subjects (59% ± 8%). Conclusions. The velocity used for the 6-minute walking distance and the 10-meter walking speed provides comparable information in patients with incomplete spinal cord injury who can perform both tests. However, tests of the preferred and maximum walking speed add information about walking capacity. Due to the easier applicability of the 10-meter walk test in the clinical setting, the authors suggest performing this test at the preferred and maximum speeds for the assessment of walking capacity by 1 month after incomplete spinal cord injury.