Walking skill can be assessed in older adults: validity of the Figure-of-8 Walk Test

Abstract

Background: The Figure-of-8 Walk Test (F8W) involves straight and curved paths and was designed to represent walking skill in everyday life.

Objective: The purposes of this study were to validate the measure in older adults with walking difficulties and to explore correlates of the curved-path walking measure not represented by a straight-path walking measure.

Design: Fifty-one community-dwelling older adults with mobility disability participated in 2 baseline visits as part of an intervention study.

Methods: The F8W time, steps, and smoothness and measures of gait (gait speed, modified Gait Abnormality Rating Scale [GARS-M]), physical function (Late Life Function and Disabilities Index [LLFDI], Survey of Activities and Fear of Falling in the Elderly [SAFFE], Gait Efficacy Scale [GES], Physical Performance Test [PPT], and fall history), and movement control and planning (gait variability, Trail Making Test B [Trails B]) were recorded in each test session. Bivariate correlations for the F8W with each variable were conducted to examine concurrent and construct validity. Adjusted linear regression analyses were performed to explore the variance in mobility explained by F8W independent of gait speed.

Results: Figure-of-8 Walk Test time correlated with gait (gait speed, r=-.570; GARS-M, r=.281), physical function (LLFDI function, r=-.469; SAFFE restriction subscale, r=.370; PPT, r=-.353), confidence in walking (GES, r=-.468), and movement control (step length coefficient of variation, r=.279; step width coefficient of variation, r=-.277; Trails B, r=.351). Figure-of-8 Walk Test steps correlated with step width variability (r=-.339) and was related to fear of falling (t=-2.50). All correlations were significant (P<.05).

Limitations: This pilot study had a small sample size, and further research is needed.

Conclusions: The F8W is a valid measure of walking skill among older adults with mobility disability and may provide information complementary to gait speed.

Figures

Figure 1.

Figure-of-8 Walk Test design. Visual schematic of the test layout illustrating an example of a completed test. Cones are represented by the large Xs. Arrows illustrate steps taken and the direction of the walking path. Numbers correspond to steps taken (straight steps: 1, 2, 7, 8, 9, 15, and 16; curve steps: 3, 4, 5, 6, 10, 11, 12, 13, and 14).

Figure 2.

Study flow chart. MMSE=Mini Mental State Examination score, COV=coefficient of variation, F8W=Figure-of-Eight Walk Test.