Minimal clinically important difference in walking velocity,gait profile score and two minute walk test for individuals with lower limb amputation |
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| Institution: | 1. Health and Rehabilitation Sciences Doctoral Program, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W 10th Avenue, Suite 228, Columbus, OH, 43210, United States;2. Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W 10th Avenue, Suite 516, Columbus, OH, 43210, United States;3. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Suite 3200, Columbus, OH, 43202, United States;1. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Suite 3200, Columbus, OH, 43202, United States;2. College of Medicine, The Ohio State University, 370 W 9th Avenue, Columbus, OH, 43210, United States;1. Health and Rehabilitation Sciences Doctoral Program, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W 10th Avenue, Suite 228, Columbus, OH, 43210, United States;2. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Suite 3200, Columbus, OH, 43202, United States;1. Center for Clinical and Translational Science, The Ohio State University, 376 W 10th Avenue, Suite 260, Columbus, OH, 43210, United States;2. Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, McCampbell Hall, 5th Floor, 1581 Dodd Drive, Columbus, OH, 43210, United States;1. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Suite 3200, Columbus, OH, 43202, United States;2. Department of Orthopaedics, The Ohio State University, 725 Prior Hall, 376 W 10th Avenue, Columbus, OH, 43210, United States;1. Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, 453 W 10th Avenue, Suite 516, Columbus, OH, 43210, United States;2. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Suite 3200, Columbus, OH, 43202, United States;1. Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, UK;2. School of Health Sciences, University of Salford, Salford, UK;3. Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Surrey, UK;4. United National Institute for Prosthetics and Orthotics Development, University of Salford, Salford, UK;5. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK;6. National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK;1. School of Health Sciences, University of Western Ontario, London, ON, Canada;2. Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada;3. Department of Physical Medicine and Rehabilitation, University of Western Ontario, London, ON, Canada;4. School of Physical Therapy, University of Western Ontario, London, ON, Canada;1. Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY;2. International Prosthetics and Orthotics, Mineola, NY;3. Program in Physical Therapy, Columbia University, New York, NY;1. Department of Health & Exercise Science, Colorado State University, CO, USA;2. School of Biomedical Engineering, Colorado State University, USA;3. Molecular, Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO, USA;1. Department of Engineering, Roma TRE University, Via Vito Volterra 62, 00146 Rome, Italy;2. Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 40100 Latina, Italy;3. Rehabilitation Centre, Policlinico Italia, Rome, Italy;4. Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy;5. Centro Protesi INAIL, Ospedale C.T.O. Andrea Alesini, Via San Nemesio, 21, 00145 Rome, Italy;6. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy |
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| Abstract: | BackgroundIndividuals with lower limb amputation are routinely assessed with a variety outcome measures, however there is a lack of published data to indicate minimal clinically important differences (MCID) for many of these outcome measures. Three such important gait-specific outcome measures include walking velocity, gait profile score (GPS) and the two minute walk test (2MWT).Research questionDetermine the MCIDs for walking velocity, GPS and 2MWT for individuals with lower limb amputation.MethodsWalking velocity and GPS (n = 60), and 2MWT (n = 119) data for individuals with unilateral transfemoral or knee disarticulation were identified retrospectively from a database held at the study centre. An anchor-based method was used with Medicare functional classification level (MFCL) acting as the impairment-related criterion, and a least-squares linear regression approach was used to calculate the gradient required for a change between MFCL levels.ResultsAn increase of 0.21 m/s (95 % CI: 0.13,0.29) for walking velocity, a reduction of 1.7° (95 % CI: -2.449,-1.097) for GPS and an increase of 37.2 m (95 % CI: 28.8,45.5) for 2MWT were found to correspond to an increase in MFCL of one level. Walking velocity, GPS and 2MWT correlated with MFCL with R2 values of 0.333, 0.322 and 0.398 respectively (p < 0.00001). The authors propose that 0.21 m/s for walking velocity, 1.7° for GPS and 37.2 m for 2MWT be used as MCID values for individuals with lower limb amputation.SignificanceThe results of this study can be used to help both researchers and clinicians to objectively evaluate if interventions for individuals with lower limb amputation are effective. |
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| Keywords: | Lower limb amputation Gait Minimal clinically important difference Prosthetic Walking velocity Gait profile score |
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