Minimal clinically important difference for change in comfortable gait speed of adults with pathology: a systematic review

Bohannon, Richard W.; Glenney, Susan Sullivan

doi:10.1111/jep.12158

Cited by 269 publications

(179 citation statements)

References 30 publications

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“…Previous studies reported clinically meaningful changes in walking speed in community-dwelling older adults for the 4-m walking test of 0.12 m/s (Perera et al 2006). More in general, small and substantial clinically meaningful changes in walking speed were reported from 0.05 to 0.10 m/s, respectively (Bohannon and Glenney 2014;Perera et al 2006). In this study, we found differences in walking speeds of 0.11 m/s for the 10-m compared to the 4-m walking test and 0.06 m/s for the 10-m compared to the 6-min walking test.…”

Section: Discussionsupporting

confidence: 44%

Walking speed in elderly outpatients depends on the assessment method

Pasma

Stijntjes

et al. 2014

AGE

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Walking speed is shown to be an important indicator of the health status and function in older adults and part of the comprehensive geriatric assessment in clinical practice. The present study aimed to assess the influence of different assessment methods on walking speed and its association with the key aspects of poor health status, i.e., the presence of low cognitive performance and cardiopulmonary disease. In 288 community-dwelling elderly (mean age 82.2±7.1 years) referred to a geriatric outpatient clinic, walking speed was assessed with the 4-m, 10-m, and 6-min walking tests. The mean walking speed assessed with the 10-m walking test was higher compared to the 4-m and 6-min walking tests (mean difference (95 % CI) 0.11 m/s (0.10; 0.13) and 0.08 m/s (0.04; 0.13), respectively). No significant difference was found in the walking speed assessed with the 4-m compared to the 6-min walking test (mean difference (95 % CI) −0.03 m/s (−0.08; 0.03)). ICCs showed excellent agreement of the 4-m with the 10-m walking test and fair to good agreement of the 6-min with the 4-m as well as 10-m walking test. The presence of low cognitive performance was negatively associated with walking speed, with the highest effect size for the 4-m walking test. The presence of cardiopulmonary disease was negatively associated with walking speed as well, with the highest effect size for the 6-min walking test. In conclusion, in the clinically relevant population of elderly outpatients, walking speed and its interpretation depends on the assessment method, which therefore cannot be used interchangeably in clinical practice.

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Section: Discussionsupporting

confidence: 44%

Walking speed in elderly outpatients depends on the assessment method

Pasma

Stijntjes

et al. 2014

AGE

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“…Besides having a significant post-intervention improvement and a medium effect size, the walking speed of the participants also improved by an average of 0.14m/s after intervention which is considered clinically important (minimal clinical important difference (MCID) = 0.10 - 0.17m/s). 42 The significant impact of the intervention on walking speed in BCS was expected, and corroborated the findings of previous multimodal PA intervention studies that focused on community-dwelling older adults. 43,44 The extent of improvement in walking speed could also potentially reduce the risk of falls.…”

Section: Discussionsupporting

confidence: 86%

A Preliminary Study on the Efficacy of a Community-Based Physical Activity Intervention on Physical Function-Related Risk Factors for Falls Among Breast Cancer Survivors

Lee

Warden

Szuck

et al. 2016

American Journal of Physical Medicine &Amp; Rehabilitation

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Objective The aim of this study was to examine the effects of a 6-week community-based physical activity (PA) intervention on physical function-related risk factors for falls among 56 breast cancer survivors (BCS) who had completed treatments. Design This was a single-group longitudinal study. The multimodal PA intervention included aerobic, strengthening and balance components. Physical function outcomes based on the 4-meter walk, chair stand, one-leg stance, tandem walk, and dynamic muscular endurance tests were assessed at 6-week pre-intervention (T1), baseline (T2), and post-intervention (T3). T1-T2 and T2-T3 were the control and intervention periods, respectively. Results All outcomes, except the tandem walk test, significantly improved after the intervention period (p < 0.05), with no change detected after the control period (p > 0.05). Based on the falls risk criterion in the one-leg stance test, the proportion at risk for falls was significantly lower after the intervention period (p = 0.04), but not after the control period. Conclusions A community-based multimodal PA intervention for BCS may be efficacious in improving physical function-related risk factors for falls, and lowering the proportion of BCS at risk for falls based on specific physical function-related falls criteria. Further larger trials are needed to confirm these preliminary findings.

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“…Clinically important difference (CID) thresholds for these outcomes have been estimated at 1.0–3.0 mL/kg/min for VO 2peak , 50–52 0.05–0.20 m/s for walking speed, 53–58 and 20–50 m for the 6-minute walk test. 58,59 Thus, on average, AEX appears to have at least some clinically meaningful impact on these outcomes.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing the Efficacy of Aerobic Exercise for Improving Fitness and Walking Capacity After Stroke

Boyne

Welge

Kissela

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective To assess the influence of dosing parameters and patient characteristics on the efficacy of aerobic exercise (AEX) post-stroke. Data Sources A systematic review was conducted using Pubmed, MEDLINE, CINAHL, PEDro and Academic Search Complete. Study Selection Studies were selected that compared AEX to a non-aerobic control group among ambulatory persons with stroke. Data Extraction Extracted outcome data included: peak oxygen consumption during exercise testing (VO2peak), walking speed and walking endurance (6-minute walk test). Independent variables of interest were: AEX mode (seated or walking), AEX intensity (moderate or vigorous), AEX volume (total hours), stroke chronicity and baseline outcome scores. Data Synthesis Significant between-study heterogeneity was confirmed for all outcomes. Pooled AEX effect size estimates (AEX change – control change) from random effects models were: VO2peak, 2.2 mL/kg/min [95% CI: 1.3, 3.1]; walking speed, 0.06 m/s [95% CI: 0.01, 0.11]; and 6-minute walk test distance, 29 m [95% CI: 15, 42]. From meta-regression, greater VO2peak effect sizes were significantly associated with higher AEX intensity and higher baseline VO2peak. Greater effect sizes for walking speed and the 6-minute walk test were significantly associated with a walking AEX mode. In contrast, seated AEX did not have a significant effect on walking outcomes. Conclusions AEX significantly improves aerobic capacity post-stroke, but may need to be task specific to impact walking speed and endurance. Higher AEX intensity is associated with better outcomes. Future randomized studies are needed to confirm these results.

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Minimal clinically important difference for change in comfortable gait speed of adults with pathology: a systematic review

Abstract: Changes in gait speed of 0.10 to 0.20 m s(-1) may be important across multiple patient groups.

Cited by 269 publications

References 30 publications

Walking speed in elderly outpatients depends on the assessment method

Walking speed in elderly outpatients depends on the assessment method

A Preliminary Study on the Efficacy of a Community-Based Physical Activity Intervention on Physical Function-Related Risk Factors for Falls Among Breast Cancer Survivors

Factors Influencing the Efficacy of Aerobic Exercise for Improving Fitness and Walking Capacity After Stroke

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