title: Clinically meaningful change in stair negotiation performance in older adults.
abstract: Stair negotiation is a key marker for independence among older adults; however, clinically meaningful change has not been established. Our objective was to establish the values of clinically meaningful change in stair negotiation time using distribution- and anchor-based approaches. Study participants were 371 community residing older adults (age≥70) in the Einstein Aging Study with time to ascend and descend 3 steps measured at baseline and at one-year follow-up. Anchor-based estimates were obtained using functional decline (defined as one-point increment in disability score) and change in self-reported walking ability over the one-year follow-up period. Small, moderate, and large meaningful change estimates were 0.28, 0.71, and 1.15 s for stair ascent time (0.31, 0.78, and 1.25 s for stair descent time) using the distribution-based approach of effect size. The estimates of meaningful decline range from 0.47 to 0.53 s for stair ascent time (0.33-0.53 s for stair descent time) using the anchor-based approach. The estimates of meaningful improvement were smaller (0.13-0.18 s for stair ascent, 0.06-0.15 for stair descent) compared to those for decline. Based on general consistency between distribution- and anchor-based approaches, preliminary criteria suggested for stair negotiation time is 0.5 s for meaningful decline and 0.2 s for meaningful improvement.
authors: Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461, United States. moh-park@kesslerfoundation.org
authors: Mooyeon
authors: M
authors: Oh-Park
authors: Subashan
authors: S
authors: Perera
authors: Joe
authors: J
authors: Verghese
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D057187:Independent Living; D008297:Male; D004856:Postural Balance / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology*; D012111:Residence Characteristics; D012189:Retrospective Studies; D018570:Risk Assessment; D013028:Space Perception / Q000502:physiology; D013997:Time Factors; D014481:United States; D014796:Visual Perception / Q000502:physiology