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== Introduction ==
== Introduction ==
[[File:Child tiptoes.jpg|right|frameless|250x250px]]
[[File:Child tiptoes.jpg|right|frameless|250x250px]]
The Functional Walking Test (FWT)also known as The 6-minute walk test(6MWT)is a submaximal exercise test designedto assessclinical populations' functionalexercise capacity.It measures the distance walked in six minutes.
The Functional Walking Test (FWT)is a simple tool used to measure functional mobility in children with [[Cerebral Palsy Introduction|Cerebral Palsy(CP)]]. The Functional Walking Test was developedto assessbalance associated with walking, and to analyze and measure the functional walking ability in children. Quinn Aoife, O'里根玛拉,Horgan弗朗西斯。心理evaluation of thefunctionalwalking test for children with cerebral palsy.Disability and Rehabilitation. 2011:33(25–26): 2397–2403.


Because of characteristicssuch asgrowth stageandage,obtaining reference values in the paediatric population is especially difficult so it would be useful to assesschildren withneurologicalormusculoskeletal conditions that affect their ability to walk.1">Mylius, C. F., Paap, D., & Takken, T. (2016). Reference value for the 6-minute walk test in children and adolescents: a systematic review. ''Expert Review of Respiratory Medicine'', ''10''(12), 1335–1352. https://doi.org/10.1080/17476348.2016.1258305</ref>
It was developed since scalessuch asthe [[Gross Motor Function Measure|Gross Motor Function Measure (GMFM)]], the Functional Mobility Scale (FMS),andthe [[Berg Balance Scale|Berg Balance Scale (BBS)]],all lack qualities that were directed towards higher functioningchildren withcerebral palsy, higher level of gross motor ability,orlimitations for children with [[hemiplegia]]. 0" />


淡水舱由切断al components,including:
A 'functional walk' can be classified as the ability to stop,start, turn, and get into a position. 0" />


* Walking 10 meters
== Audience ==
* Ascending and descending a step
Itisexpected that alltheitems onthe test can beperformed bya4-year old without motor impairments. 0" />
* Walking on tiptoes and heels.
The childistimed during each task, andtheresults are used to assess their functional mobility.A ''''functional walk'''' can be classified astheability to stop, start, turn, and get into a position. Quinn Aoife, O'Regan Myra, Horgan Frances. Psychometric evaluation of the functional walkingtestfor children with cerebral palsy. Disability and Rehabilitation. 2011:33(25–26): 2397–2403.
The FWT is a reliable and valid assessment tool that has been used in several studies to evaluate children with various conditions, including [[Cerebral Palsy Introduction|cerebral palsy]], [[Muscular Dystrophy|muscular dystrophy]], and [[Spina Bifida|spina bifida]]. Itcan beused to assess changes inachild's mobility over time and to evaluate the effectiveness of interventions.1" />


== Development of the Functional Walking Test ==
== Development of the Functional Walking Test ==
TheFunctional Walking Test (FWT)was developedby K.Barry and J. Hussey in 2004as amodificationofthe 6-Minute Walk Test (6MWT),whichwasoriginally developed for adults. The FWT was specifically designed for use in children with neurological or musculoskeletal conditions that affect their ability to walk.2">Barry K, Hussey J.Development of theFunctional Walking Testfor children with cerebral palsy. J Pediatr Orthop. 2004;24(2):215-8. doi:10.1097/01241398-200403000-00020. PMID: 15076585.>
Thescalewasinitiallydevelopedin several stages.It was primarily developedasan ordinal scale, fromafocus groupofclinicians and therapists who identified characteristics and items of functional walking. Subsequent to this,items were removed and reliability testingwasconducted. 0"/>
[[File:Child stairs.jpg|right|frameless|240x240px]]
TheFunctional Walking Testconsists of 11 tests, divided into 5 categories:0"/>


== Method of use ==
* Kneeling
'''Equipment Required:'''
*站从跪
* Standing
* [[Gait Analysis in Cerebral Palsy|Walking]]
* Stairs


* Stopwatch or timer
* Tape measure
*步骤:步骤,大约是15厘米(6英寸es) high is needed for the second task of ascending and descending a step.
* Assisted devices: Assisted devices such as walkers, crutches or canes may be required for some children during the test.


'''Set-Up:'''
Specific rules and guidelines of the test are explained in a manual that comes with the test. 0" />


* Open space thatisat least 10 meters (33 feet) long.
The maximum scoreis23.
* Flat surface and no obstacles.


'''Patient Instructions:'''
Of these five categories, items examined include the ability to walk on one's knees, to ascend and descend an incline, and to walk on a narrow beam. These actions test for aspects of [[balance]] and [[Postural Control|postural control]] necessary for [[gait]]. 0" />


* During the FWT, the childisinstructedtowalk 10 meters (33 feet) as quickly and safely as possible,with or without an assistive device if needed. The child's time is measured using a stopwatch, starting when the child's foot crosses the starting line and stopping when the child's foot crosses the finish line.
The testisquick and easytoconduct,taking less than10minutestoscore.Itisdone onaspecial scoring template, andtakes minimal equipmentandspacetoconduct. 0" />
* After completing the10-meter walk, the child is askedtoascend and descend a step that is approximately 15 cm (6 inches) high.The child's timeismeasured usingastopwatch,starting when the child's foot touches the first stepandstopping when the child's foot touches the ground on the other side.
* Next, the child is asked to walk on their tiptoes for 10 meters (33 feet). The child's time is measured using a stopwatch, starting when the child's foot crosses the starting lineandstopping when the child's heel touches the ground.
* Finally, the child is askedtowalk on their heels for 10 meters (33 feet). The child's time is measured using a stopwatch, starting when the child's foot crosses the starting line and stopping when the child's toes touch the ground.2" />


[[File:10MWTpathrepresentation.jpg|center|frameless|845x845px]]
== Functional Walking Test (FWT) and the International Classification of Functioning, Disability, and Health (ICF) ==
The FWT was designed to be a quick and simple assessment of functional walking ability. This is classified to fit within the 'activity' category of the[[International Classification of Functioning, Disability and Health (ICF)|International Classification of Functioning, Disability, and Health (ICF)]]. It's specific purpose is to assess physical function and balance associated with gait, without targeting any other areas of gross motor function.


== Functional Walking Test (FWT) andtheInternational Classification of Functioning,Disability, andHealth (ICF) ==
It does not address any other aspects oftheICF,such as,Bodily StructureandFunction, or Participation. =":0" />


* The FWT was designed to be a quick and simple assessment of functional walking ability. This is classified to fit within the 'activity' category of the [[International Classification of Functioning, Disability and Health (ICF)|International Classification of Functioning, Disability, and Health (ICF)]]. It's specific purpose is to assess physical function and balance associated with gait, without targeting any other areas of gross motor function.
When a more holistic profile of a child is needed, the FWT can be administered with other measure or tests, which address the other respective aspects of the ICF.
* It does not address any other aspects of the ICF, such as, Bodily Structure and Function, or Participation.
*When a more holistic profile of a child is needed, the FWT can be administered with other measure or tests, which address the other respective aspects of the ICF.


== Reliability and Validity ==
== Reliability and Validity ==
The FWT has been shown to be a reliable and valid assessment tool for measuring functional mobility in children with various neurological or musculoskeletal conditions. One study evaluatedthe reliability of theFWT in children with cerebral palsy and found high intra-rater and inter-rater reliability,with intraclass correlation coefficients (ICCs) ranging from 0.96to0.98. Ko J, Kim M, Hwang J, Kim Y, Kim Y, Lee S. Validityandreliabilityof thefunctional walkingtest for children with cerebral palsy.Disabil Rehabil.2020;42(1):123-128.doi: 10.1080/09638288.2018.1533264.Epub 2018 Nov 6.PMID: 30398044.
To assessthe reliabilityand validityof theFunctional Walking Test,it was comparedtosections DandEof theGMFM. The GMFM is a clinical measure that was intended totest forchanges in gross motor function inchildren with cerebral palsy.The GMFM is a scale used as a benchmark, which has gone through various tests of reliability and validity.When a test and retest, of the FWT and the GMFM, at a future date, were compared.The tests using the FWT had a high correlation in relation to the GMFM, which indicated that the FWT had a high reliability and validity.Correlation values were 0.86 and 0.87 at two different times, with a correlation coefficient greater than 0.76 indicating a strong association.It was seen that subjects achieved less than the top score when completing the FWT, whereas they would easily achieve the top score when completing the GMFM.This indicatesthat the FWTmay be presenting more challenging tasks thantheGMFM. 0" />
Another study foundthat the FWThad good concurrent validity when compared tothe6-minute walk test in children with spina bifida.3" />
In addition, the FWT has been shown to be sensitive to changes in walking ability over time, and can be used to monitor the effects of different interventions on functional mobility in children with cerebral palsy. One study found that changes in FWT scores correlated with changes in walking speed and gross motor function in children with cerebral palsy.
Overall, the FWT is a reliable and valid tool for assessing functional mobility in children with neurological or musculoskeletal conditions.
== References ==
== References ==


Latest revision as of 10:58, 6 July 2023

Original Editor-Kapil Narale

Top Contributors-Kapil Narale,Aya AlhindiandKim Jackson

Introduction[edit|edit source]

Child tiptoes.jpg

The Functional Walking Test (FWT) is a simple tool used to measure functional mobility in children withCerebral Palsy (CP). The Functional Walking Test was developed to assess balance associated with walking, and to analyze and measure the functional walking ability in children.[1]

It was developed since scales such as theGross Motor Function Measure (GMFM), the Functional Mobility Scale (FMS), and theBerg Balance Scale (BBS), all lack qualities that were directed towards higher functioning children with cerebral palsy, higher level of gross motor ability, or limitations for children withhemiplegia.[1]

A 'functional walk' can be classified as the ability to stop, start, turn, and get into a position.[1]

Audience[edit|edit source]

It is expected that all the items on the test can be performed by a 4-year old without motor impairments.[1]

Development of the Functional Walking Test[edit|edit source]

The scale was initially developed in several stages. It was primarily developed as an ordinal scale, from a focus group of clinicians and therapists who identified characteristics and items of functional walking. Subsequent to this, items were removed and reliability testing was conducted.[1]

Child stairs.jpg

The Functional Walking Test consists of 11 tests, divided into 5 categories:[1]

  • Kneeling
  • Standing from kneeling
  • Standing
  • Walking
  • Stairs


Specific rules and guidelines of the test are explained in a manual that comes with the test.[1]

The maximum score is 23.[1]

Of these five categories, items examined include the ability to walk on one's knees, to ascend and descend an incline, and to walk on a narrow beam. These actions test for aspects ofbalanceandpostural controlnecessary forgait.[1]

The test is quick and easy to conduct, taking less than 10 minutes to score. It is done on a special scoring template, and takes minimal equipment and space to conduct.[1]

Functional Walking Test (FWT) and the International Classification of Functioning, Disability, and Health (ICF)[edit|edit source]

The FWT was designed to be a quick and simple assessment of functional walking ability. This is classified to fit within the 'activity' category of theInternational Classification of Functioning, Disability, and Health (ICF). It's specific purpose is to assess physical function and balance associated with gait, without targeting any other areas of gross motor function.[1]

It does not address any other aspects of the ICF, such as, Bodily Structure and Function, or Participation.[1]

When a more holistic profile of a child is needed, the FWT can be administered with other measure or tests, which address the other respective aspects of the ICF.[1]

Reliability and Validity[edit|edit source]

To assess the reliability and validity of the Functional Walking Test, it was compared to sections D and E of the GMFM. The GMFM is a clinical measure that was intended to test for changes in gross motor function in children with cerebral palsy. The GMFM is a scale used as a benchmark, which has gone through various tests of reliability and validity. When a test and retest, of the FWT and the GMFM, at a future date, were compared. The tests using the FWT had a high correlation in relation to the GMFM, which indicated that the FWT had a high reliability and validity. Correlation values were 0.86 and 0.87 at two different times, with a correlation coefficient greater than 0.76 indicating a strong association. It was seen that subjects achieved less than the top score when completing the FWT, whereas they would easily achieve the top score when completing the GMFM. This indicates that the FWT may be presenting more challenging tasks than the GMFM.[1]

References[edit|edit source]

  1. ↑1.001.011.021.031.041.051.061.071.081.091.101.111.121.13Quinn Aoife, O'Regan Myra, Horgan Frances. Psychometric evaluation of the functional walking test for children with cerebral palsy. Disability and Rehabilitation. 2011:33(25–26): 2397–2403.
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