Changes in gait speed of 0.10 to 0.20 m s(-1 ) may be important across multiple patient groups
RATIONALE , AIMS AND OBJECTIVES Walking speed is an important performance variable , but information on the minimal clinical ly important difference ( MCID ) for the measure has not been consoli date d. In this review , we aim ed to summarize information on the MCID for change in comfortable gait speed measurements for patients with pathology .
Minimally important clinical difference of the Timed 25-Foot Walk Test: results from a randomized controlled trial in patients with multiple sclerosis
Abstract Background : Limited data define what constitutes a clinical ly significant change on the Timed 25-Foot Walk ( T25FW ) in multiple sclerosis ( MS ) ; however , most studies suggest a value of ≥20 % . Analyses were undertaken to estimate the minimally important clinical difference ( MICD ) in walking speed as measured by the T25FW in patients with MS . Methods : Data from MS-F203 , a r and omized trial of dalfampridine extended release tablets , 10 mg twice daily ( prolonged-release/sustained-release fampridine outside the US ) in patients with MS , were used to calculate the MICD , as an absolute and percentage value , for the T25FW test . Both anchor- ( using the Clinician Global Impression [ CGI ] ) and distribution-based ( 2.77 × st and ard error of measurement or 0.50 st and ard deviation units ) approaches were used . Using the anchor-based estimations , the proportion of patients in the dalfampridine and placebo groups achieving at least a MICD in MS-F203 was determined . Results : A correlation between change in T25FW speed during and CGI at the end of double-blind period was found ( Spearman r = −0.39 , p < 0.0001 ) . Irrespective of treatment group , participants categorized ‘ minimally improved ’ by the CGI had a mean improvement in T25FW speed of 0.36 feet/second or a 17.2 % relative change from an average baseline walking speed of 2.1 feet/second ( effect size = 0.49 ) ; values representing MICDs . MICD estimates of 0.35 and 0.37 feet/second were generated using distribution-based approaches . In MS-F203 , a greater proportion of patients receiving dalfampridine achieved ≥0.36 feet/second ( 12/72 vs. 78/224 , p = 0.007 ) and a 17.2 % ( 11/72 vs. 87/224 , p = 0.0005 ) improvement in T25FW speed compared to placebo . Limitations : MICD estimates from this analysis may not apply to patients with different disease characteristics from MS-F203 . A different anchor may result in a different MICD estimation . Conclusion : Our MICD estimate for an improvement in T25FW is close to previous estimates of 20 % change . Dalfampridine may improve walking speed in a considerable proportion of patients by a clinical ly relevant amount
Changes in gait speed of 0.10 to 0.20 m s(-1 ) may be important across multiple patient groups
RATIONALE , AIMS AND OBJECTIVES Walking speed is an important performance variable , but information on the minimal clinical ly important difference ( MCID ) for the measure has not been consoli date d. In this review , we aim ed to summarize information on the MCID for change in comfortable gait speed measurements for patients with pathology .