Assessing the Accuracy of the Figure-of-Eight Walk Test in Distinguishing Between Household and Community Ambulation in Post-Stroke Individuals

Abstract

Introduction: Traditional post-stroke walking assessments often prioritize linear trajectories, failing to capture the complexity of everyday ambulation. Navigating the intricacies of everyday life requires adaptability that extends beyond the confines of linear paths. It involves addressing dynamic challenges, such as turns, varied terrains, and unexpected obstacles, which are often not adequately captured by traditional post-stroke walking assessments. The Figure-of-Eight Walk Test (F8WT) compensates for this limitation by assessing walking ability in varied scenarios. However, investigations into its accuracy for differentiating walking capabilities post-stroke are notably lacking. This study aimed to investigate the precision of the F8WT in distinguishing between household and community walkers among individuals post-stroke.

Methods: Sixty-two stroke participants, capable of walking independently or with minimal assistance (one assistant at most), were categorized into household and community walkers based on gait speed measurements. The F8WT was then administered, with its discriminative accuracy assessed using the area under the receiver operating characteristic (ROC) curve. Additionally, an optimal cutoff value distinguishing the two categories was calculated.

Results: The F8WT demonstrated robust discriminative potential, achieving the area under the curve (AUC) of 0.96 (95% CI = 0.91–1.00) on the ROC curve analysis. It registered a sensitivity of 97.60% and a specificity of 84.20%. A critical cutoff point was established at >11.20 seconds for effective categorization.

Conclusions: The F8WT is a potent assessment tool, successfully differentiating between household and community walking abilities among stroke survivors. This precise demarcation underscores its applicability in individualized post-stroke rehabilitative planning.