Is the Walking Adaptability Ladder test for Kids (WAL-K) reliable and valid in ambulatory children with Cerebral Palsy?

Disabil Rehabil. 2024 Feb 24:1-7. doi: 10.1080/09638288.2024.2321325. Online ahead of print.

Abstract

Purpose: Walking adaptability is essential for children to participate in daily life. We studied whether the Walking Adaptability Ladder test for Kids (WAL-K) is reliable and valid for assessing walking adaptability in 6-12 year old ambulatory children with Cerebral Palsy (CP).

Materials and methods: Thirty-six children with CP (26 GMFCS-level I, 10 GMFCS-level II) completed the single and double run of the WAL-K. Intra- and inter-rater reliability were determined by Intraclass Correlation Coefficients (ICCs). Construct validity was determined by comparing WAL-K scores between 122 typically developing (TD) and CP children taking age into account, comparing WAL-K scores between CP children in GMFCS-levels I and II, and correlating WAL-K scores with scores of the 10 times 5 m Sprint Test (10 × 5mST).

Results: ICCs for reliability varied between 0.997 and 1.000. WAL-K scores were significantly higher (i.e., worse) in CP children compared to TD children (p < 0.001), and in children in GMFCS-level II compared to GMFCS-level I (p = 0.001). Significant positive correlations were found between the WAL-K and 10 × 5 mST (single run r = .89, double run r = .84).

Conclusions: The WAL-K shows to be a promising reliable, valid, and easy-to-use tool for assessing walking adaptability in children with CP. Responsiveness to change has yet to be evaluated.

Keywords: Cerebral Palsy; Walking Adaptability Ladder test for Kids; children; psychometric properties; walking adaptability.

Plain language summary

Walking adaptability is an essential skill for children to participate in daily life, yet there is no validated clinical test for children with Cerebral Palsy (CP).We recently developed the Walking Adaptability Ladder test for Kids (WAL-K) and we here tested its reliability and validity in children with CP.Application of the WAL-K in children with CP yielded excellent intra- and inter-rater reliability and a good construct validity.The WAL-K shows to be a promising reliable, valid, and easy-to-use tool to assess walking adaptability in children with CP.