Development, validity, and test-retest reliability of a new neurocognitive functional performance test: The choice-reaction hop test.

OBJECTIVES: To validate a choice-reaction hop test (CRHT) by assessing differences in timing versus the side-hop test (SHT), and to determine the CRHT's test-retest reliability. DESIGN: Test-retest reliability. SETTING: Laboratory. PARTICIPANTS: Forty-nine healthy adults participated (16 female; age = 22.7 ± 3.4 years; height = 174.9 ± 9.1 cm; mass = 75.4 ± 14.8 kg). MAIN OUTCOME MEASURES: Participants completed three trials each of the SHT and the CRHT in a counterbalanced order. Participants returned one-week later to repeat the CRHT. The fastest and the mean of the three trials were compared. RESULTS: Participants took significantly longer to complete the CRHT (Mean across 3 trials = 21.4 ± 3.4s, Fastest trial = 19.7 ± 3.0s) compared to the traditional SHT (10.4 ± 2.0s, p < 0.001). The CRHT demonstrated good-excellent test-retest reliability across testing days for both the mean across 3 trials (r = 0.890, p < 0.001, SEM = 1.13) and the fastest trial (r = 0.828, p < 0.001, SEM = 1.24). CONCLUSION: Compared to the SHT, the CRHT took longer to complete indicating its ability to stress neurocognitive function during an FPT. The CRHT demonstrated good-excellent test-retest reliability, which may allow it to be a useful measure in serial evaluations such as during rehabilitation benchmarking. The CRHT may be an effective FPT to assess combined physical and neurocognitive function to assist clinicians in evidence-based decision-making.

The Effect of Split-Belt Treadmill Interventions on Step Length Asymmetry in Individuals Poststroke: A Systematic Review With Meta-Analysis.

BACKGROUND: Individuals poststroke experience gait asymmetries that result in decreased community ambulation and a lower quality of life. A variety of studies have utilized split-belt treadmill training to investigate its effect on gait asymmetry, but many employ various methodologies that report differing results. OBJECTIVE: The purpose of this meta-analysis was to determine the effects of split-belt treadmill walking on step length symmetry in individuals poststroke both during and following training. METHODS: A comprehensive search of PubMed/MEDLINE, CINAHL, Web of Science, and Scopus was conducted to find peer-reviewed journal articles that included individuals poststroke that participated in a split-belt treadmill walking intervention. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to assess risk of bias. Pooled Hedge's g with random effects models were used to estimate the effect of split-belt training on step length symmetry. RESULTS: Twenty-one studies were assessed and included in the systematic review with 11 of them included in the meta-analysis. Included studies had an average STROBE score of 16.2 ± 2.5. The pooled effects for step length asymmetry from baseline to late adaptation were not significant (g = 0.060, P = .701). Large, significant effects were found at posttraining after a single session (g = 1.04, P < .01), posttraining after multiple sessions (g = -0.70, P = .01), and follow-up (g = -0.718, P = .023). CONCLUSION: Results indicate split-belt treadmill training with the shorter step length on the fast belt has the potential to improve step length symmetry in individuals poststroke when long-term training is implemented, but randomized controlled trials are needed to confirm the efficacy of split-belt treadmill training.