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Commentary on “Predictors of Standardized Walking Obstacle Course Outcome Measures in Children With and Without Developmental Disabilities”

Dannemiller, Lisa PT, DSc, PCS; Hymes, Lisa PT, MS

Pediatric Physical Therapy: Winter 2011 - Volume 23 - Issue 4 - p 374
doi: 10.1097/PEP.0b013e3182352696
Clinical Bottom Line

University of Colorado Aurora, Colorado

Integrated Pediatric Therapies, P.C. Denver, Colorado

The authors declare no conflict of interest.

“How can I apply this information in clinical practice?”

This study further demonstrated the use of the Standardized Walking Obstacle Course (SWOC), a test previously found to be a safe, reliable, and valid measure designed to determine functional ambulation capacity. The current study was conducted with 440 children from 3 to 21 years old who could follow test directions and walk without an assistive device, 19% of whom had disabilities.

The authors' strongest conclusions were in line with what clinicians can expect:

* Children with disabilities will take a longer time, more steps, more stumbles, and more steps off the path than the median performance on the test. This is consistent with previous evidence that gait parameters differ between children with and without disabilities.

* Children around 7 years old and children who weigh more than 59 lb will walk faster and take fewer steps. These results support previous evidence that clinicians can expect the functional ambulation of children to mature/stabilize around the age of 7 years.

* The SWOC can be used as a screening tool to assist in determining the need for further testing by examining how environmental demands (walking with tray and walking with shaded glasses) change functional ambulation. With limited time, the 1 best condition that the clinician can use for screening is walking with a tray.

* The SWOC appears to be better at determining disability (problems with functional ambulation) than assuring that a child does not have a disability.

“What should I be mindful about when reading this article?”

* The reader will have to study previous publications about the SWOC to learn obstacle course design, group means, and standard deviations.

* SWOC's capacity to detect change has not yet been reported. This, along with a lack of information about test result interpretation, currently limits the clinician to the use of the SWOC primarily as a screening tool.

* Other analyses of child characteristics such as body mass index, race/ethnicity, and orthotics, were provided but were not as strongly predictive for clinical application.

* Although this is a test that thoughtfully examines the person, task, and environment in the context of functional activity, unless one has video capability, it may take 2 examiners to collect and record the 4 sets of data necessary for this test.

Lisa Dannemiller, PT, DSc, PCS

University of Colorado

Aurora, Colorado

Lisa Hymes, PT, MS

Integrated Pediatric Therapies, P.C.

Denver, Colorado

© 2011 Lippincott Williams & Wilkins, Inc.