To assess the reliability of 6 gait performance tests in individuals with chronic mild to moderate post-stroke hemiparesis. An intra-rater (between occasions) test-retest reliability study. Fifty men and women (mean age 58+/-6.4 years) 6-46 months post-stroke. The Timed "Up & Go" test, the Comfortable and the Fast Gait Speed tests, the Stair Climbing ascend and descend tests and the 6-Minute Walk test were assessed 7 days apart. Reliability was evaluated with the intraclass correlation coefficient (ICC(2,1)), the Bland & Altman analysis, the standard error of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%). Test-retest agreements were high (ICC(2,1) 0.94-0.99) with no discernible systematic differences between the tests. The standard error of measurement (SEM%), representing the smallest change that indicates a real (clinical) improvement for a group of individuals, was small (< 9%). The smallest real difference (SRD%), representing the smallest change that indicates a real (clinical) improvement for a single individual, was also small (13-23%). These commonly used gait performance tests are highly reliable and can be recommended to evaluate improvements in various aspects of gait performance in individuals with chronic mild to moderate hemiparesis after stroke.

To assess the age-related loss of muscle mass and to determine the mechanisms behind this aging atrophy, the muscle structure and fiber type composition have been estimated, using invasive and noninvasive techniques. Limb muscles from older men and women are 25–35% smaller and have significantly more fat and connective tissue than limb muscles from younger individuals. Comparisons of muscle biopsies from younger and older individuals reveal that type 2 (fast-twitch) fibers are smaller in the old, while the size of type 1 (slow-twitch) fibers is much less affected. Studies of whole muscle cross sections also show a significantly smaller number of muscle fibers, a significantly lower relative type 2 fiber area, and a significant increase in fiber type grouping with increasing age. These results indicate a gradual decrease in sizelvolume with advancing age, accompanied by a replacement by fat and connective tissue. This aging atrophy seems to be due to a reduction in both number and size of muscle fibers, mainly of type 2, and is to some extent caused by a slowly progressive neurogenic process.

Lexell JE, Downham DY: How to assess the reliability of measurements in rehabilitation. Am J Phys Med Rehabil 2005;84:719–723. To evaluate the effects of rehabilitation interventions, we need reliable measurements. The measurements should also be sufficiently sensitive to enable the detection of clinically important changes. In recent years, the assessment of reliability in clinical practice and medical research has developed from the use of correlation coefficients to a comprehensive set of statistical methods. In this review, we present methods that can be used to assess reliability and describe how data from reliability analyses can aid the interpretation of results from rehabilitation interventions.