Sharon L. Held

Standardized Walking Obstacle Course (SWOC): reliability and validity of a new functional measurement tool for children.

Purpose: This study reports reliability of the Standardized Walking Obstacle Course (SWOC) and concurrent validity with the Timed Up and Go (TUG) for use in children with and without developmental disabilities. Methods: Seventy-three children completed the SWOC and TUG during each of two sessions scheduled one week apart. Two raters took measures of time and number of steps on the SWOC to correlate with the same measures on the TUG. Results: Very high interrater reliabilities for time (intercorrelation coefficient [ICC] 0.99) and number of steps (ICC 0.94–0.99) noted. High intrarater reliabilities recorded for time (ICC 0.83–0.97) and number of steps (ICC 0.84–0.96). Significant correlations (p < 0.05) between the TUG and SWOC were moderate to very high for time (r = 0.72–0.90) and number of steps (r = 0.63–0.92). Conclusion: The SWOC demonstrates good reliability within and between raters and concurrent validity with the TUG for use with children to establish their functional ambulation capability. The SWOC could easily be used in any setting for any child who can follow the directions and walk without an assistive device. Further testing is needed of the use of the SWOC to detect change and measure the extent of the environments influence on activity and participation for different populations of children.

Effects of orthoses on upright functional skills of children and adolescents with cerebral palsy.

Purpose: Most research details the influence of orthoses on impairments in children with cerebral palsy. The purpose of this study was to determine the effect of orthoses on multiple tests of function. Methods: The researchers used the Standardized Walking Obstacle Course (SWOC), Pediatric Balance Scale (PBS), performance on individualized goals related upright function, and self‐reports of comfort and stability with and without orthoses to examine 28 children (5.4‐19.1 years of age) with cerebral palsy. Results: No significant differences were found in performance on the SWOC and PBS with and without orthoses. Only 18% of the children performed better on an individualized goal with their orthoses, but 48% of the children reported more feelings of comfort and stability while wearing orthoses. Conclusions: Results of this study bring into question the use of orthoses to improve functional balance and ambulation in children with cerebral palsy. (Pediatr Phys Ther 2002;14:199‐207) cerebral palsy/rehabilitation, child, gait, equilibrium, comparative study, orthotic devices.

Predictors of Standardized Walking Obstacle Course Outcome Measures in Children With and Without Developmental Disabilities

Purpose: This study was designed to determine which characteristics of children predict measures on the Standardized Walking Obstacle Course (SWOC). Methods: SWOC testing was performed under 3 conditions: (1) walk, (2) walk with a tray, and (3) walk wearing shaded glasses. Trials consisted of standing up, walking the course in 1 direction, and sitting down. Children (n = 440) completed 2 trials per condition. Trial measures included time, and numbers of steps, stumbles, and steps off the path. Relationships were evaluated using Chi-square analyses and significant predictors were determined by multiple logistic regression analyses. Sensitivity and specificity were calculated to determine the accuracy of disability as a predictor. Results: Age, weight, and disability were the strongest predictors (P < .05). Increased age and weight predicted shorter time and fewest steps. Disability predicts longer time and most steps. Conclusion: The SWOC is appropriate to screen children for disabilities in functional ambulation.

Reference data for performances on the standardized walking obstacle course in children developing typically.

PURPOSE To establish reference performance groups on the Standardized Walking Obstacle Course (SWOC) a pathway to screen ambulation for children developing typically. METHODS SWOC tests ambulation under three conditions: walk (W), walk with tray (WT) and walk wearing sunglasses (WG). One trial consisted of standing up, walking the course in one direction and sitting down. Children (n=355) completed two trials per condition. Trial measures included time to complete (seconds) and numbers of steps, stumbles, and steps off path. RESULTS Trial 1 and trial 2 for time and number of steps are significantly different (p=0.0005), but highly correlated (r=0.93 and r=0.96) therefore their average was used to establish reference data. Gender was not a significant factor. Age and height predict performances in all conditions, but measures between age groups were not always significantly different. Significant different measures by height groups could be established across all conditions, therefore reference data was established using three height groups. CONCLUSION Reference values will assist clinicians to compare a childs performance on the SWOC based on an individual height because this can vary within and between ages thus screening for possible ambulation limitations.