Determining Meaningful Changes in Gait Speed After Hip Fracture

• Published in: Physical therapy 2006-06, Vol.86 (6), p.809-816
• Main Authors: Palombaro, Kerstin M, Craik, Rebecca L, Mangione, Kathleen K, Tomlinson, James D
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Care and treatment; Data Interpretation, Statistical; Female; Fracture fixation; Fractures; Gait - physiology; Gait disorders; Gerontology; Health aspects; Hip fracture repair; Hip fractures; Hip Fractures - physiopathology; Hip joint; Humans; Male; Middle Aged; Older people; ROC Curve; Sensitivity and Specificity; Walking; Walking - physiology
• ISSN: 0031-9023; 1538-6724
• DOI: 10.1093/ptj/86.6.809

Older subjects after hip fracture walk more slowly than age-matched peers. The extent to which they walk more slowly is difficult to define because the standard error of the measure (SEM), sensitivity to change, and clinically important change have not been reported for gait speed. The purposes of this study were to quantify the SEM for habitual and fast gait speeds among older subjects after hip fracture, to define the minimal detectable change (MDC), and to estimate the minimal clinically important difference (MCID) for habitual gait speed. A sample of 92 subjects after hip fracture was drawn from 3 studies that collected gait speed data. An estimate of the MDC was determined by use of the SEM. The MCID was determined from expert opinion and from a receiver operating characteristic (ROC) curve. The SEM and the MDC were 0.08 m/s and 0.10 m/s for habitual speed and fast speed, respectively. Both methods of MCID estimation identified 0.10 m/s as a meaningful change in habitual gait speed. The estimated MCID for gait speed of 0.10 m/s was supported by clinical expert opinion and the cutoff point of the ROC curve.