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 .
Admission Ambulation Velocity Predicts Length of Stay and Discharge Disposition Following Stroke in an Acute Rehabilitation Hospital
Poststroke functional outcome and discharge disposition are influenced by age , lesion location and size , severity of neurological insult , prior functional ability , and social support . The effect of admission ambulation velocity on length of stay and discharge disposition has not been previously reported . Design . Prospect i ve , cohort study . Setting . Design ated acute stroke rehabilitation unit . Method . 373 patients consecutively admitted to a design ated inpatient stroke rehabilitation unit were studied . The study sample was divided into 2 groups , based on admission ambulation velocity ( meters/second ) during a 2-min timed walk test . Fast ambulators had an ambulation velocity of greater than 0.15 m/s , whereas slow ambulators had an ambulation velocity of 0.15 m/s or less , and also included nonambulators . Interventions . None . Outcome Measures . Primary outcome measures were length of stay and discharge disposition . Secondary outcome measures were change in the Functional Independence Measure ( FIM ) scores and change in ambulation velocity per week . Continuous , ordinal , and nominal variables were analyzed using the Student t test , Mann-Whitney U test , and chi-square test , respectively . Sensitivity , specificity , and positive and negative predictive values assessed admission ambulation velocity as a predictor of discharge disposition . Results . Patient variables for slow ambulators ( n = 226 ) versus fast ambulators ( n = 147 ) were as follows : age ( 68 ± 13 SD vs. 69 ± 12 , P = 0.32 ) , male-female ratio ( 100:126 vs. 78:69 , P = 0.09 ) , admission total FIM score ( 52 ± 17 vs. 77 ± 16 , P < 0.0001 ) , change in total FIM score ( 20 ± 12 vs. 16 ± 12 , P < 0.003 ) , change in ambulation velocity per week ( 0.05 ± 0.06 vs. 0.13 ± 0.30 , P < 0.0001 ) , length of stay in days ( 30 ± 28 vs. 17 ± 19 , P < 0.0001 ) , and discharge disposition : home/skilled nursing facility ( 133/91 vs. 133/13 , P < 0.0001 ) . Sensitivity , specificity , and positive and negative predictive values ( based on chi-square analyses ) for admission fast ambulators as a predictor of home discharge were 0.5 , 0.87 , 0.91 , and 0.41 , respectively . Admission ambulation velocity alone correctly identified discharge disposition in 78 % of the patient population , based on logistic regression analysis ( P < 0.0001 ) . Conclusion . Admission ambulation velocity can predict length of stay and discharge disposition poststroke . This effect is independent of age and admission total FIM score
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 .