The Speed Precision ObsTacle CourSe (SPOTS): a reliable, valid and sensitive obstacle course for assessing walking adaptability for people with central neurological disorders.

Abstract

This prospective study examined the psychometric properties of the Speed Precision ObsTacle courSe (SPOTS), a six-item, triangle-shaped obstacle course to assess walking adaptability in individuals with a central neurological disorder (CND). Inter- and intra-rater reliability, validity and sensitivity of the SPOTS were evaluated in adults with CND undergoing inpatient rehabilitation. The SPOTS was performed on 2 consecutive days, and 1 month later, alongside clinical assessments on the first and last day. Completion time was recorded, and three raters performed clinician-rated assessments for motor and cognitive function based on video recordings. Reliability of the clinician-rated SPOTS score was assessed with Intraclass Correlation Coefficients (ICC), Bland-Altman, and weighted Kappa analysis; validity with Spearman rank correlation coefficients and sensitivity to change with the minimal detectable change (MDC). Thirty-five independent walkers (FAC ≥3) with CND were recruited. The SPOTS showed excellent inter-rater (ICC: 0.90-0.93) and intra-rater reliability (ICC: 0.91-0.96). Adequate to excellent correlations (<i>r</i> = 0.36-0.66) were found with other common balance and gait assessments. An MDC value of 4.63 points (6.4% of SPOTS) was found. The SPOTS is a new, promising, reliable, valid and sensitive tool for assessing advanced walking adaptability in patients with CND.