Is the Walking Adaptability Ladder test for Kids (WAL-K) reliable and valid in ambulatory children with Cerebral Palsy?

PURPOSE: Walking adaptability is essential for children to participate in daily life. We studied whether the Walking Adaptability Ladder test for Kids (WAL-K) is reliable and valid for assessing walking adaptability in 6-12 year old ambulatory children with Cerebral Palsy (CP).

MATERIALS AND METHODS: Thirty-six children with CP (26 GMFCS-level I, 10 GMFCS-level II) completed the single and double run of the WAL-K. Intra- and inter-rater reliability were determined by Intraclass Correlation Coefficients (ICCs). Construct validity was determined by comparing WAL-K scores between 122 typically developing (TD) and CP children taking age into account, comparing WAL-K scores between CP children in GMFCS-levels I and II, and correlating WAL-K scores with scores of the 10 times 5 m Sprint Test (10 × 5mST).

RESULTS: ICCs for reliability varied between 0.997 and 1.000. WAL-K scores were significantly higher (i.e., worse) in CP children compared to TD children ( p  < 0.001), and in children in GMFCS-level II compared to GMFCS-level I ( p  = 0.001). Significant positive correlations were found between the WAL-K and 10 × 5 mST (single run r = .89, double run r = .84).

CONCLUSIONS: The WAL-K shows to be a promising reliable, valid, and easy-to-use tool for assessing walking adaptability in children with CP. Responsiveness to change has yet to be evaluated.