The Groningen Meander Walking Test: A Dynamic Walking Test for Older Adults With Dementia

• Published in: Physical therapy 2014-02, Vol.94 (2), p.262-272
• Main Authors: Bossers, Willem J R, van der Woude, Lucas H V, Boersma, Froukje, Scherder, Erik J A, van Heuvelen, Marieke J G
• Format: Article
• Language: English
• Subjects: Accelerometers; Aged; Aged patients; Aged, 80 and over; Care and treatment; Clinical medicine; Dementia; Dementia - physiopathology; Disability Evaluation; Elderly patients; Feasibility Studies; Female; Function tests (Medicine); Gait Disorders, Neurologic - physiopathology; Geriatric assessment; Humans; Male; Memory; Netherlands; Nursing homes; Older people; Physical therapy; Physiological aspects; Reproducibility of Results; Walking; Walking - physiology
• ISSN: 0031-9023; 1538-6724
• DOI: 10.2522/ptj.20130077

Current dynamic walking tests, used in studies with older adults with dementia, rely strongly on healthy cognitive and physical function. Therefore, the Groningen Meander Walking Test (GMWT) was developed specifically for people with dementia. The aim of the GMWT is to measure dynamic walking ability by walking over a meandering curved line, with an emphasis on walking speed and stepping accuracy, while changing direction. The purpose of this study was to investigate the feasibility, test-retest reliability, and minimal detectable change (MDC) of the GMWT. A repeated-measures design was used. Forty-two people with dementia participated in the study. Adherence rate, adverse events, repetition of instructions during test performance, test duration, and number of oversteps were assessed. The adherence rate was excellent, with no adverse events. No repetitive instructions were given during test performance, and test duration was short (mean=17.16 seconds) with few oversteps (mean=1.94 oversteps). Test-retest reliability for participants without a walking device was excellent for the GMWT time score (intraclass correlation coefficient [ICC]=.942), with an MDC of 2.96 seconds. Test-retest reliability for participants with a 4-wheeled walker (4WW) was moderate (ICC=.837), with an MDC of 10.35 seconds. For the overstep score, a marginal ICC of .630 was found, with an MDC of 4.38 oversteps. No fall data were available, and there was a volunteer bias. The GMWT is a feasible test for people with dementia. With the GMWT time score, a reliable and sensitive field test to measure walking abilities in older adults with dementia is available. The GMWT overstep score can be used to give information about the execution according to protocol and should be emphasized during the instructions. Future studies need to investigate the validity of the GMWT.