RehabMeasures Instrument
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  2. Stops Walking When Talking

Stops Walking When Talking

Last Updated

Purpose

The SWWT determines fall risk in older adults by noting whether or not they need to stop when walking after being engaged in conversation. Evaluates the ability to successfully dual task walking with talking.

Acronym SWWT

Area of Assessment

Balance – Non-vestibular
Executive Functioning
Functional Mobility
Gait

Assessment Type

Observer

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Parkinson's Disease & Movement Disorders

Populations

Stroke
Parkinson's Disease
Older Adults and Geriatric Care

Key Descriptions

  • *Please note that this is a different test from “Walking While Talking.”
  • Residents in a long term care facility were engaged in conversation while walking down a corridor of ~150 meters. If residents stopped walking when engaged in conversation, the test was considered positive.
  • Older Adults (Lundin-Olsson, 1997):
    1) 58 institutionalized residents, cognitive impairment and depression were not excluded. (mean age [SD] 80.1 [6.1] years; 72% women).
    2) Subjects were able to walk with or without aids, 12 stopped walking when beginning a conversation.
    3) 10 fell during 6 mo follow up. Walk from home room to assessment, did they stop walking when talking.
  • Observations: specificity = 95%; sensitivity = 48%; positive predictive value = 83%; negative predictive value = 76%.
  • Parkinson’s Disease (Bloem, 2000):
    1) 38 iPD subjects, 35 controls.
    2) SWWT was abnormal in 4 patients (2 fallers, 2 non-fallers).
    3) 14 iPD reported 119 falls, 5 controls reported 7 falls.
    4) Within PD group observations: SWWT poor sensitivity (14.3% and adequate specificity (91.7%); poor predictor of falls in PD.
    5) Patients with cognitive impairment were excluded.

Number of Items

1

Time to Administer

Less than 5 minutes

Required Training

No Training

Age Ranges

Elderly Adult

65 +

years

Instrument Reviewers

Updated with references for the PD population by Jeffrey Hoder, PT, DPT, NCS and the PD EDGE task force of the Neurology Section of the APTA in 2013.

Body Part

Lower Extremity

ICF Domain

Activity

Measurement Domain

Activities of Daily Living

Considerations

  • Lundin-Olsson’s original study in 1997 did not exclude for depression or cognitive impairment.
  • Bloem’s study in 2000 excluded those with PD and cognitive impairment.

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Older Adults and Geriatric Care

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Criterion Validity (Predictive/Concurrent)

(Lundin-Olsson, 1997: 58 institutionalized residents, (mean age [SD] 80·1 [6·1] years; 72% women).cognitive impairment and depression were not excluded. Subjects were able to walk with or without aids)

  • Specificity = 95%, sensitivity = 48%. Positive predictive value = 83%; negative predictive value = 76%.  

 

(Bloem, 2000: 14 iPD, 5 controls; Patients with cognitive impairment were excluded). 

  • Within PD group: SWWT poor sensitivity (14.3% and adequate specificity (91.7%) Poor predictor of falls in PD. 

 

(Hyndman, 2004: Sixty three participants (36 men, 27 women; mean (SD) age 68.4 (10.6)) were recruited. Four subjects had a brainstem lesion, 30 had right hemisphere, and 29 left hemisphere infarctions. Mean time since onset of stroke was 20 months (range 2–72)). 

  • Within CVA group: For all fallers (> 1) the positive predictive value of SWWT was 62% (16/26), the negative predictive value 62% (23/37), specificity 70% (23/33) and sensitivity 53% (16/30). For repeat fallers (> 2) the positive predictive value of SWWT was 42% (11/26), the negative predictive value 89% (33/37), specificity 69% (33/48) and sensitivity 73% (11/15).

Parkinson's Disease

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Criterion Validity (Predictive/Concurrent)

(Bloem, 2000: 14 iPD, 5 controls; Patients with cognitive impairment were excluded). 

  • Within PD group: SWWT poor sensitivity (14.3% and adequate specificity (91.7%) Poor predictor of falls in PD. 

Stroke

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Criterion Validity (Predictive/Concurrent)

(Hyndman, 2004: Sixty three participants (36 men, 27 women; mean (SD) age 68.4 (10.6)) were recruited. Four subjects had a brainstem lesion, 30 had right hemisphere, and 29 left hemisphere infarctions. Mean time since onset of stroke was 20 months (range 2–72)). 

  • Within CVA group: For all fallers (> 1) the positive predictive value of SWWT was 62% (16/26), the negative predictive value 62% (23/37), specificity 70% (23/33) and sensitivity 53% (16/30). For repeat fallers (> 2) the positive predictive value of SWWT was 42% (11/26), the negative predictive value 89% (33/37), specificity 69% (33/48) and sensitivity 73% (11/15).

Bibliography

Beauchet, O., Annweiler, C., et al. (2009). "Stops walking when talking: a predictor of falls in older adults?" Eur J Neurol 16(7): 786-795. 

Bloem, B. R., Grimbergen, Y. A., et al. (2000). ""Stops walking when talking" does not predict falls in Parkinson's disease." Ann Neurol 48(2): 268. 

Bootsma‐van der Wiel, A., Gussekloo, J., et al. (2003). "Walking and Talking as Predictors of Falls in the General Population: The Leiden 85‐Plus Study." Journal of the American Geriatrics Society 51(10): 1466-1471. 

Hyndman, D. and Ashburn, A. (2004). "Stops walking when talking as a predictor of falls in people with stroke living in the community." J Neurol Neurosurg Psychiatry 75(7): 994-997. 

Lundin-Olsson, L., Nyberg, L., et al. (1997). ""Stops walking when talking" as a predictor of falls in elderly people." Lancet 349(9052): 617. 

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