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  • 1.
    Sjöholm, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Rehabilitation Centre, Region Jönköping County, Jönköping, Sweden.
    Hägg, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Futurum, Region Jönköping County, Jönköping, Sweden.
    Nyberg, Lars
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Rolander, Bo
    Futurum, Region Jönköping County, Jönköping, Sweden.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Futurum, Region Jönköping County, Jönköping, Sweden.
    The Cone Evasion Walk test: Reliability and validity in acute stroke2019In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, no 1, article id e1744Article in journal (Refereed)
    Abstract [en]

    Objective

    To estimate the reliability and validity of the Cone Evasion Walk test (CEW), a new test assessing the ability to evade obstacles, in people with acute stroke.

    Methods

    To estimate the reliability of the CEW, video recordings of 20 people with acute stroke performing the test were assessed by 10 physiotherapists on two occasions, resulting in a total of 400 ratings. Patients performed the CEW (n = 221), functional ambulation classification (FAC; n = 204), Timed Up and Go (TUG; n = 173), TUG cognitive (TUG‐cog; n = 139), Serial 7s attention task from the Montreal Cognitive Assessment (MoCA‐S7; n = 127), and the Star Cancellation Test (SCT; n = 151). These tests and side of lesion (n = 143) were used to examine construct validity. The predictive validity was evaluated in relation to falls during the following 6 months (n = 203).

    Results

    The intraclass correlation coefficients for intrarater and interrater reliability were 0.88–0.98. For validity, there were significant correlations between the CEW and FAC (rs = −0.67), TUG (rs = 0.45), MoCA‐S7 (rs = −0.36), and SCT total score (rs = −0.36). There was a significant correlation between the number of cones touched on the left side and the proportion of cancelled stars on the left (rs = −0.23) and right (rs = 0.23) side in the SCT. Among right hemisphere stroke participants (n = 79), significantly more persons hit cones on the left side (n = 25) than the right side (n = 8), whereas among those with a left hemisphere stroke (n = 64) significantly more persons hit cones on the right side (n = 11) than the left (n = 3). Cox regression showed that participants who touched four to eight cones had an increased risk of falls over time (hazard ratio 2.11, 95% CI [1.07, 4.17]) compared with those who touched none.

    Conclusion

    The new CEW test was reliable and valid in assessing the ability to evade obstacles while walking and to predict falls in patients with acute stroke.

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