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Hollman, J H; Beckman, B A; Brandt, R A; Merriwether, E N; Williams, R T; Nordrum., J T
Mayo School of Health Sciences, and Dept. of Physical Medicine & Rehabilitation, Mayo Clinic, Rochester, MN.
Purpose/Hypothesis: Clinicians can measure and document a patient's gait velocity as a means for providing an objective assessment of functional improvement during rehabilitation following hip fracture. Interpreting the magnitude of change in gait velocity that is clinically meaningful, however, can be difficult. The purpose of this study was to calculate the minimum detectable change (MDC) as a measure of responsiveness of gait velocity in patients hospitalized following surgical fixation for traumatic hip fractures. Subjects: Fifteen adults age 65 or older with acute, traumatic, unilateral, intra‐capsular hip fractures were recruited from St. Marys Hospital in Rochester, MN, to participate in this study. Subjects included six men and nine women who provided consent to participate in the study. Materials/Methods: Subjects performed two timed trials of the 10 meter walk test (10 MWT). Subjects were permitted to walk with the use of a gait aid, most often a rolling walker, but no verbal or tactile cueing was given to aid ambulation. Investigators used a stopwatch to measure the time it took for subjects to complete the 10 MWT and subsequently calculated gait velocity. The mean and standard deviation (SD) of subjects' first 10 MWT trial was calculated and a test‐retest (ICC3,1) reliability coefficient was calculated using gait velocity data obtained from the second trial of the 10 MWT. The SD and testretest reliability coefficient data were then used to calculate the MDC at a 95% level of confidence. Results: Across subjects, mean gait velocity was equal to 15 cm/s with a SD of 5 cm/s. The test‐retest reliability, estimated with the ICC3,1 coefficient, was equal to 0.813 (95% CI = 0.515 to 0.936). The MDC was equal to 6 cm/s. Conclusions: Based on these preliminary results, the gait velocity of a patient in the acute phase of rehabilitation following surgical fixation of a traumatic, unilateral hip fracture must improve by 6 cm/s or more in order to designate the change as being meaningful and beyond the bounds of measurement error. Clinical Relevance: Clinicians may use this data to establish a threshold for interpreting meaningful change in gait velocity.
Copyright © 2007 the Section on Geriatrics of the American Physical Therapy Association
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