title: Meaningful improvement in gait speed in hip fracture recovery.
abstract: OBJECTIVE
  To estimate meaningful improvements in gait speed observed during recovery from hip fracture and to evaluate the sensitivity and specificity of gait speed changes in detecting change in self-reported mobility.
  
  
  METHODS
  Secondary longitudinal data analysis from two randomized controlled trials
  
  
  METHODS
  Twelve hospitals in the Baltimore, Maryland, area.
  
  
  METHODS
  Two hundred seventeen women admitted with hip fracture.
  
  
  METHODS
  Usual gait speed and self-reported mobility (ability to walk 1 block and climb 1 flight of stairs) measured 2 and 12 months after fracture.
  
  
  RESULTS
  Effect size-based estimates of meaningful differences were 0.03 for small differences and 0.09 for substantial differences. Depending on the anchor (stairs vs walking) and method (mean difference vs regression), anchor-based estimates ranged from 0.10 to 0.17 m/s for small meaningful improvements and 0.17 to 0.26 m/s for substantial meaningful improvement. Optimal gait speed cutpoints yielded low sensitivity (0.39-0.62) and specificity (0.57-0.76) for improvements in self-reported mobility.
  
  
  CONCLUSIONS
  Results from this sample of women recovering from hip fracture provide only limited support for the 0.10-m/s cut point for substantial meaningful change previously identified in community-dwelling older adults experiencing declines in walking abilities. Anchor-based estimates and cut points derived from receiver operating characteristic curve analysis suggest that greater improvements in gait speed may be required for substantial perceived mobility improvement in female hip fracture patients. Furthermore, gait speed change performed poorly in discriminating change in self-reported mobility. Estimates of meaningful change in gait speed may differ based on the direction of change (improvement vs decline) or between patient populations.
authors: Departments of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, USA. dalley@epi.umaryland.edu
authors: Dawn E
authors: DE
authors: Alley
authors: Gregory E
authors: GE
authors: Hicks
authors: Michelle
authors: M
authors: Shardell
authors: William
authors: W
authors: Hawkes
authors: Ram
authors: R
authors: Miller
authors: Rebecca L
authors: RL
authors: Craik
authors: Kathleen K
authors: KK
authors: Mangione
authors: Denise
authors: D
authors: Orwig
authors: Marc
authors: M
authors: Hochberg
authors: Barbara
authors: B
authors: Resnick
authors: Jay
authors: J
authors: Magaziner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005684:Gait; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D020127:Recovery of Function; D016138:Walking