Article

Based on its ability to predict consequential outcomes, gait speed has been
recommended as a "vital sign" for older individuals. Recommendations
notwithstanding, the value of comfortable gait speed as a measure is limited
unless clinicians can use it to identify real changes in performance over time.
The purpose of this study, therefore, was to broadly describe the responsiveness
of comfortable gait speed measured from patients admitted to short-term
rehabilitation. For 136 consecutive patients who met inclusion and exclusion
criteria (mean age=73.6 years), information regarding assistance, device use, and
speed was obtained. Speed was measured as patients walked at a comfortable speed
over 5.2m. The admission gait speed was a mean (SD) .40 (.18)m/s. The discharge
speed was .59 (.20)m/s. The change in speed from admission to discharge (mean
15.1 days) was .20 (.16)m/s. The minimal detectable change (95%) was .13 m/s. The
effect size was 1.11; the standardized response mean was 1.25. Based on receiver
operating characteristic curve analysis, the minimal clinically important
difference associated with 4 anchors (1 - subjective change in overall walking, 2
- change in assistance required, 3 - change in assistive device used, and 4 -
change in speed based classification) ranged from .10 to .18 m/s. On the basis of
multiple distribution- and anchor-based indicators, comfortable gait speed can be
considered a responsive measure for patients undergoing short-term
rehabilitation.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

Langue : ANGLAIS