The Psychometric Properties of the Cone Evasion Walk Test in Patients With Knee Osteoarthritis.
Kevser Sevik Kacmaz, Bayram Unver, Vasfi Karatosun
The Cone Evasion Walk Test is a reliable, well-tolerated obstacle-avoidance walking test for knee OA patients.
A change of more than 2.02 seconds between sessions is likely real. It adds multidirectional turning to what the TUG already measures.
Key findings
1The CEW showed excellent within-day reliability (ICC 0.97, 95% CI 0.87–0.99) and a minimum detectable change of 2.02 seconds, meaning a score shift beyond that is likely a real change in the patient.
2The CEW correlated moderately with the TUG (r = 0.58, p < 0.001), indicating partial overlap in what they measure but not redundancy.
3All patients completed the test without increased pain or adverse effects, and only one patient touched a cone once, supporting its feasibility in knee OA.
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What it does not show
Both trials were done on the same day one hour apart, so this is within-day repeatability, not the day-to-day test-retest reliability a clinician would rely on in follow-up. The second trial was slightly faster (0.18 s), suggesting a small residual practice effect despite two warm-up attempts. Single clinic, single assessor, small sample of 36 patients; generalisability to other settings or populations is untested. Fall history was self-reported, which is vulnerable to memory gaps and recall bias. Symptom duration was not recorded, so it is unclear how long-standing the knee OA was in each patient. The CEW did not correlate with past falls or with the WOMAC self-report, so it cannot be read as a fall-risk predictor or a substitute for the patient's own account of function.
Declared interests
No funding was received. The authors declare no conflicts of interest.
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