Key result
Timed Backward Walk test distinguishes chronic stroke from healthy controls with ~0.97 AUC.
Why the study?
Backward walking is an important but under-assessed component of functional mobility after stroke, and the psychometric properties of the Timed Backward Walk test in stroke have not been systematically established.
Does the Timed Backward Walk test demonstrate valid and reliable psychometric properties for assessing walking capability and balance in people with chronic stroke?
Cross-Sectional (n=90)
Does the Timed Backward Walk test demonstrate valid and reliable psychometric properties for assessing walking capability and balance in people with chronic stroke?
Effect estimate: AUC 0.968 (95% CI 0.934-1.000)
Absolute Event Rate: 17.38% vs 4.85%
p-value: p=<0.001
The Timed Backward Walk test is a reliable, feasible, and sensitive tool for assessing mobility and balance deficits in people with chronic stroke, effectively discriminating them from healthy older adults.
OBJECTIVE: To examine the psychometric properties of the Timed Backward Walk test in people with stroke. DESIGN: Cross-sectional study. SUBJECTS: 60 people with stroke and 30 healthy adults aged 55 years and older. METHODS: Participants performed the Timed Backward Walk test and standard clinical assessments. Discriminative validity was evaluated using receiver operating characteristic curve. Reliability (one-week test-retest, inter-rater, intra-rater) was assessed using intraclass correlation coefficients. Construct validity was examined through correlations with motor function, strength, balance, and gait measures. RESULTS: People with chronic stroke took significantly longer to complete the test than healthy adults (p < 0.001), with an area under the curve of 0.968 and an optimal cut-off of 7.22 s. Test-retest, inter-rater, and intra-rater reliability were all excellent. The standard error of measurement was 1.62 s and the minimal detectable change was 4.49 s. The complete time showed strong positive correlations with functional mobility and gait speed measures (ρ = 0.840-0.897) and moderate negative correlations with balance, lower-limb motor function, and ankle dorsiflexor strength (ρ = -0.408 to -0.647). The Timed Backward Walk test demonstrated excellent reliability, discriminative validity, and construct validity in people with chronic stroke. It is a feasible and sensitive complement to forward gait assessments.
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Qin et al. (2026) conducted a cross-sectional in Stroke (n=90). Chronic stroke vs. Healthy adults was evaluated on Timed Backward Walk (TBW) test time and discriminative ability (AUC 0.968, 95% CI 0.934-1.000, p=<0.001). The Timed Backward Walk test demonstrated outstanding discriminative ability between people with chronic stroke and healthy older adults, with an area under the curve of 0.968 and an optimal cut-off of 7.22 seconds.
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