Assessing the quality of walking in adults with chronic pain: The development and preliminary psychometric evaluation of the Bath Assessment of Walking Inventory

Walking is fundamental to many activities that are detrimentally affected by chronic pain. When in pain, people adapt how they walk. This article reports the development of an observational rating scale for the assessment of the quality of walking in adults with chronic pain called the Bath Assessment of Walking Inventory. The BAWI was designed explicitly for clinical and research use. A review of the literature on movement assessment, and a professional focus group, yielded 36 items capturing specific characteristics of walking that were organised into 11 domains. Investigation into the psychometric properties reduced the final measure to 23 items in 8 domains that demonstrated good internal consistency (Cronbach 0.71) and adequate intra (Kappa 0.61-0.98) and inter-rater reliability (Kappa 0.61-0.98). Validity was established in comparison with well-used measures of functioning. Further independent study is required to develop this instrument. A robust measure of walking will enable accurate clinical assessment, and the investigation of psychosocial and biomechanical influences on walking quality, and of the communicative function of pain related movement.