500 Section - Development and measurement properties of the Walking Aids Skills Test© (WAST©): a multiphase, multi-design feasibility study.

Globally, an estimated 1.3 billion people, about 16% of the world’s population, live with a disability that may require using walking aid (WA) such as a cane, walker, or crutch to support independent mobility. However, no standardized tools exist to assess proficiency in using WA. The Walking Aids Skills Test© (WAST©) was developed as a structured and objective method for evaluating walking-aid use. This study aimed to develop the WAST© and evaluate its feasibility, reliability, and validity.


Design:

The WAST© was developed following the Wheelchair Skills Test framework and refined through expert consultation, resulting in a 15-item Version 1.0.  A convenience sample of healthcare trainees and community-dwelling individuals using WA was recruited. Participants completed the following at baseline and 2-4 weeks later: WAST©, Timed Up and Go (TUG), and either the 2-Minute Walk Test (2MWT) or 6-Minute Walk Test (6MWT).  Feasibility and measurement properties (construct and validity, internal consistency, test-retest reliability, intra-rater reliability, and inter-rater reliability) were assessed.


Results:

Sixty-five healthcare trainees (mean±SD age 23.7±4.6 years, 51 women) and 56 WA users (61.7±16 years, 36 women) participated. Mean WAST© administration time was 22±9 minutes. The test was well-tolerated, with no adverse events. Content validity was confirmed through expert consensus (n=8). Reliability analyses revealed adequate internal consistency (α = 0.83), good test-retest reliability (ICC = 0.72), excellent intra-rater reliability (ICC = 0.99), and good inter-rater reliability (ICC = 0.89). Validity was acceptable, supported by known-groups comparisons (novice WA users vs. experienced, p = 0.04, Cohen’s d = 0.9), and moderate correlations with mobility measures (2MWT, r = 0.40 and 6MWT, r = –0.50).

Conclusion:

The WAST© is feasible and safe with adequate reliability and validity. Findings support WAST© as a standardized tool for assessing walking-aid use. Further studies are needed to confirm its applicability across diverse populations with a range of WA experiences.