PMID- 24947198
OWN - NLM
STAT- MEDLINE
DCOM- 20150102
LR  - 20191210
IS  - 1538-6724 (Electronic)
IS  - 0031-9023 (Linking)
VI  - 94
IP  - 11
DP  - 2014 Nov
TI  - Minimal clinically important difference of the functional gait assessment in 
      older adults.
PG  - 1594-603
LID - 10.2522/ptj.20130596 [doi]
AB  - BACKGROUND: The Functional Gait Assessment (FGA) is commonly used to measure 
      walking balance. The minimal clinically important difference (MCID) has yet to be 
      determined for the FGA. OBJECTIVE: The purposes of this study were to determine: 
      (1) the MCID in the FGA for older community-dwelling adults relative to patients' 
      and physical therapists' estimates of change and (2) the extent of agreement 
      between patients' and physical therapists' estimates of change. DESIGN: This 
      study was a prospective case series. METHODS: Patients and physical therapists 
      rated the amount of change in balance while walking after an episode of physical 
      therapy for balance retraining on a 15-point global rating of change (GROC) 
      scale. Weighted kappa statistics were calculated to express agreement between 
      patients' and physical therapists' GROC ratings. Functional Gait Assessment 
      change scores were plotted on receiver operating characteristic curves. A cutoff 
      of +3 on the GROC was the criterion used for important change. The optimal FGA 
      change cutoff score for MCID was determined, and sensitivity (SN), specificity 
      (SP), and likelihood ratios (LRs) were calculated. RESULTS: One hundred 
      thirty-five community-dwelling older adults (average age=78.8 years) and 14 
      physical therapists participated. There was poor agreement between the patients' 
      and therapists' ratings of change (weighted kappa=.163). The estimated MCID value 
      for the FGA using physical therapists' ratings of change as an anchor was 4 
      points (SN=0.66, SP=0.84, LR+=4.07, LR-=0.40). No accurate value for the FGA MCID 
      could be determined based on the patients' ratings of change. LIMITATIONS: The 
      small sample size was a limitation. CONCLUSION: Poor agreement between 
      therapists' and patients' ratings indicate the need for further communication 
      relative to patient goals. The 4-point MCID value for the FGA can be used for 
      goal setting, tracking patient progress, and program evaluation.
CI  - (c) 2014 American Physical Therapy Association.
FAU - Beninato, Marianne
AU  - Beninato M
AD  - M. Beninato, PT, DPT, PhD, Graduate Programs in Physical Therapy, MGH Institute 
      of Health Professions, 36 1st Ave, CNY, Boston, MA 02129 (USA). 
      mbeninato@mghihp.edu.
FAU - Fernandes, Arlene
AU  - Fernandes A
AD  - A. Fernandes, PT, MS, Physical Therapy, Brookline Healthcare Center, Brookline, 
      Massachusetts.
FAU - Plummer, Laura S
AU  - Plummer LS
AD  - L.S. Plummer, PT, DPT, MS, NCS, Physical Therapy, MGH Institute of Health 
      Professions.
LA  - eng
PT  - Journal Article
DEP - 20140619
PL  - United States
TA  - Phys Ther
JT  - Physical therapy
JID - 0022623
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Gait/*physiology
MH  - Gait Disorders, Neurologic/physiopathology/psychology/*rehabilitation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Postural Balance/*physiology
MH  - Prospective Studies
MH  - Recovery of Function/*physiology
MH  - Self Report
MH  - Sensation Disorders/physiopathology/psychology/*rehabilitation
MH  - Sensitivity and Specificity
EDAT- 2014/06/21 06:00
MHDA- 2015/01/03 06:00
CRDT- 2014/06/21 06:00
PHST- 2014/06/21 06:00 [entrez]
PHST- 2014/06/21 06:00 [pubmed]
PHST- 2015/01/03 06:00 [medline]
AID - ptj.20130596 [pii]
AID - 10.2522/ptj.20130596 [doi]
PST - ppublish
SO  - Phys Ther. 2014 Nov;94(11):1594-603. doi: 10.2522/ptj.20130596. Epub 2014 Jun 19.