Background and Purpose. 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. Subjects. A sample of 92 subjects after hip fracture was drawn from 3 studies that collected gait speed data. Methods. 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. Results. 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. Discussion and Conclusion. 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. [Palombaro KM, Craik RL, Mangione KK, Tomlinson JD. Determining meaningful changes in gait speed after hip fracture.Phys Ther. 2006; 86:809–816.]

The SEMs were similar to previously reported values and can be used when working with African American and white older adults. Estimates of MDC were calculated to assist in clinical interpretation.

No abstract

Impairments (summed lower extremity strength) and risk factors (perception of general health and balance confidence) are important predictors of gait speed in elders after hip fracture.

No abstract

Purpose: Following hip fracture, patients demonstrate greatly reduced walking speeds 1 year later compared with age-matched elders. The purpose of our study was to examine the factors that relate to gait speed in patients after hip fracture. Methods: Forty-two men and women (mean age 79 AE 7.5 years) who sustained a hip fracture participated in this study. Linear regression analysis was used to determine a statistical model that best predicted gait speed, the dependent variable. Gait speed was measured with a computerized gait mat. The independent variables were age, sex, height, weight, time post-fracture, medications, mental status, depression, balance confidence, Medical Outcome Studies, Short Form (SF-36), balance, and lower extremity isometric force. All subjects were discharged from physical therapy services, and measurements were taken, on average, 17 weeks post-fracture. Results: Using stepwise regression, 72% of the variance in gait speed was explained by summed lower extremity strength normalized by body weight, general health (SF-36), and balance confidence (Activities-specific Balance Confidence Scale). Conclusions: Impairments (summed lower extremity strength) and risk factors (perception of general health and balance confidence) are important predictors of gait speed in elders after hip fracture. RÉ SUMÉ DES POINTS CLÉ SObjectif : Les patients qui subissent une fracture à la hanche marchent beaucoup moins vite un an aprè s une fracture que leurs pairs du mê me â ge. L'objectif de cette é tude est d'examiner les facteurs lié s à la vitesse de la marche chez les patients ayant subi une fracture de la hanche. Me´thodologie : Quarante-deux hommes et femmes (â ge moyen de 79 AE 7,5 ans) ayant subi une fracture à la hanche ont participé à cette é tude. L'analyse de ré gression liné aire a servi à dé terminer un modè le statistique pré voyant le mieux la vitesse de la marche qui constitue la variable dé pendante. La vitesse de la marche a é té mesuré e à l'aide d'un tapis de marche é lectronique. Les variables indé pendantes sont l'â ge, le sexe, la grandeur, le poids, le temps é coulé aprè s la fracture, les mé dicaments, l'é tat mental, la dé pression, la confiance de l'é quilibre, Medical Outcome Studies, Short Form (SF-36), l'é quilibre, et la force isomé trique du membre infé rieur. Pour tous les sujets, les services de physiothé rapie avaient pris fin et les mesures avaient é té prises, en moyenne, 17 semaines aprè s la fracture. Re´sultats : À l'aide de l'analyse de ré gression par degré s, 72 % de la variance dans la vitesse de marche s'expliquaient par une force totale du membre infé rieur normalisé e par le poids corporel, l'é tat de santé (SF-36), et la confiance de l'é quilibre (É chelle de confiance de l'é quilibre spé cifique aux activité s). Conclusions : Les dé ficiences (force totale du membre infé rieur) ainsi que les facteurs de risque (perception de l'é tat de santé gé né ral et de la confiance de l'é quilibre) sont d'importantes variables explicatives de la vitesse de la marc...

The described use of this instrumentation appears to generate reliable measurements of static weight distribution. With further testing, this system may provide useful information related to manual wheelchair prescription and adjustment.

No abstract