PMID- 20022995
OWN - NLM
STAT- MEDLINE
DCOM- 20100304
LR  - 20220321
IS  - 1538-6724 (Electronic)
IS  - 0031-9023 (Print)
IS  - 0031-9023 (Linking)
VI  - 90
IP  - 2
DP  - 2010 Feb
TI  - Meaningful gait speed improvement during the first 60 days poststroke: minimal 
      clinically important difference.
PG  - 196-208
LID - 10.2522/ptj.20090079 [doi]
AB  - BACKGROUND: When people with stroke recover gait speed, they report improved 
      function and reduced disability. However, the minimal amount of change in gait 
      speed that is clinically meaningful and associated with an important difference 
      in function for people poststroke has not been determined. OBJECTIVE: The purpose 
      of this study was to determine the minimal clinically important difference (MCID) 
      for comfortable gait speed (CGS) associated with an improvement in the modified 
      Rankin Scale (mRS) score for people between 20 to 60 days poststroke. DESIGN: 
      This was a prospective, longitudinal, cohort study. METHODS: The participants in 
      this study were 283 people with first-time stroke prospectively enrolled in the 
      ongoing Locomotor Experience Applied Post Stroke (LEAPS) multi-site randomized 
      clinical trial. Comfortable gait speed was measured and mRS scores were obtained 
      at 20 and 60 days poststroke. Improvement of >or=1 on the mRS was used to detect 
      meaningful change in disability level. RESULTS: Mean (SD) CGS was 0.18 (0.16) m/s 
      at 20 days and 0.39 (0.22) m/s at 60 days poststroke. Among all participants, 
      47.3% experienced an improvement in disability level >or=1. The MCID was 
      estimated as an improvement in CGS of 0.16 m/s anchored to the mRS. LIMITATIONS: 
      Because the mRS is not a gait-specific measure of disability, the estimated MCID 
      for CGS was only 73.9% sensitive and 57.0% specific for detecting improvement in 
      mRS scores. CONCLUSIONS: We estimate that the MCID for gait speed among patients 
      with subacute stroke and severe gait speed impairments is 0.16 m/s. Patients with 
      subacute stroke who increase gait speed >or=0.16 m/s are more likely to 
      experience a meaningful improvement in disability level than those who do not. 
      Clinicians can use this reference value to develop goals and interpret progress 
      in patients with subacute stroke.
FAU - Tilson, Julie K
AU  - Tilson JK
AD  - Division of Biokinesiology and Physical Therapy, University of Southern 
      California, 1540 E Alcazar St, CHP 155, Los Angeles, CA 90089, USA. 
      tilson@usc.edu
FAU - Sullivan, Katherine J
AU  - Sullivan KJ
FAU - Cen, Steven Y
AU  - Cen SY
FAU - Rose, Dorian K
AU  - Rose DK
FAU - Koradia, Cherisha H
AU  - Koradia CH
FAU - Azen, Stanley P
AU  - Azen SP
FAU - Duncan, Pamela W
AU  - Duncan PW
CN  - Locomotor Experience Applied Post Stroke (LEAPS) Investigative Team
LA  - eng
GR  - P30 AG028740/AG/NIA NIH HHS/United States
GR  - R01 CA092123/CA/NCI NIH HHS/United States
GR  - R01 NS050506/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20091218
PL  - United States
TA  - Phys Ther
JT  - Physical therapy
JID - 0022623
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Disability Evaluation
MH  - *Gait
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Physical Therapy Modalities/instrumentation/*standards
MH  - *Recovery of Function
MH  - Regression Analysis
MH  - Sensitivity and Specificity
MH  - Stroke/physiopathology
MH  - *Stroke Rehabilitation
MH  - United States
MH  - Walking
PMC - PMC2816032
FIR - Paris, Trevor
IR  - Paris T
FIR - Stewartc, Deborah
IR  - Stewartc D
FIR - Gallichio, Joann
IR  - Gallichio J
FIR - Freed, Mitchell
IR  - Freed M
FIR - Dolske, Michelle
IR  - Dolske M
FIR - Moore, Craig
IR  - Moore C
FIR - Brutsch, Bettina
IR  - Brutsch B
FIR - Adams, H Richard
IR  - Adams HR
FIR - Hoang, Diemha
IR  - Hoang D
FIR - Correa, Anita
IR  - Correa A
FIR - Stenehjem, Jerome
IR  - Stenehjem J
FIR - Hon, Roxanne
IR  - Hon R
FIR - McLeod, Molly
IR  - McLeod M
FIR - Alexander, David
IR  - Alexander D
FIR - Hershberg, Julie
IR  - Hershberg J
FIR - Ith-Chang, Samneang
IR  - Ith-Chang S
FIR - Duncan, Pamela W
IR  - Duncan PW
FIR - Behrman, Andrea L
IR  - Behrman AL
FIR - Sullivan, Katherine J
IR  - Sullivan KJ
FIR - Azen, Stanley P
IR  - Azen SP
FIR - Wu, Samuel S
IR  - Wu SS
FIR - Dobkin, Bruce H
IR  - Dobkin BH
FIR - Nadeau, Stephen E
IR  - Nadeau SE
FIR - Azen, Stanley P
IR  - Azen SP
FIR - Wu, Samuel S
IR  - Wu SS
FIR - Cen, Steven
IR  - Cen S
FIR - Rose, Dorian K
IR  - Rose DK
FIR - Tilson, Julie K
IR  - Tilson JK
FIR - Hayden, Sarah
IR  - Hayden S
FIR - Coull, Bruce M
IR  - Coull BM
FIR - Noser, Elizabeth A
IR  - Noser EA
FIR - Parides, Michael K
IR  - Parides MK
FIR - Wolf, Steven L
IR  - Wolf SL
EDAT- 2009/12/22 06:00
MHDA- 2010/03/05 06:00
PMCR- 2010/08/01
CRDT- 2009/12/22 06:00
PHST- 2009/12/22 06:00 [entrez]
PHST- 2009/12/22 06:00 [pubmed]
PHST- 2010/03/05 06:00 [medline]
PHST- 2010/08/01 00:00 [pmc-release]
AID - ptj.20090079 [pii]
AID - 2009-0079 [pii]
AID - 10.2522/ptj.20090079 [doi]
PST - ppublish
SO  - Phys Ther. 2010 Feb;90(2):196-208. doi: 10.2522/ptj.20090079. Epub 2009 Dec 18.