01865nas a2200205 4500000000100000008004100001653002400042653001200066100001400078700001500092700001400107700001500121700001700136700001500153245009600168300001400264490000700278050000600285520136800291 2004 d10aPeer Reviewed Paper10aChecked1 ade Bie R.1 avan Loo M.1 aBosman J.1 aHassett L.1 aLanzarone S.1 aMoseley A.00aEcological validity of walking speed assessment after traumatic brain injury: a pilot study a341-348. 0 v19 aN3 a

OBJECTIVE: To assess the ecological validity of walking speed measurement after traumatic brain injury (TBI). PARTICIPANTS: Ten people with TBI who could walk independently and were participating in a rehabilitation program. DESIGN: Walking speed on 3 clinical gait tests (comfortable and fast pace over a 10-m distance and a 6-minute walk test) in 3 "natural" environments (a corridor in a brain injury rehabilitation unit, a car park of a metropolitan shopping center, and inside a metropolitan shopping center). Normative data were collected for 275 able-bodied pedestrians as they walked in the 3 natural environments. RESULTS: For subjects with TBI, agreement between the speeds used in the clinical gait tests and the natural environments was poor (intraclass correlation coefficient [ICC] values ranged from -0.24 to 0.63). The closest speed match was the comfortable paced 10-m walk test and walking in a corridor of a brain injury rehabilitation unit (ICC 0.63). Able-bodied pedestrians walked at significantly faster speeds than did subjects with TBI in all 3 natural environments. CONCLUSIONS: Comfortable walking speed appears to have the highest ecological validity of the clinical gait tests investigated. Practice in natural and more complex environments should be incorporated into walking rehabilitation programs for people with TBI.