Assessing gait efficacy in older adults: An analysis using item response theory.
Subashan Perera, Jessie VanSwearingen, Valerie Shuman and 1 others
PMID 32028078WHAT IT FOUND
The 10-item walking confidence questionnaire could be shortened to 7 items, and possibly 3 with small losses.
It still gives clinicians similar information about older adults' confidence in walking.
Key findings
01The half-mile walking item provided little information for discriminating among walking confidence levels.
02Shorter mGES versions had correlations of at least 0.96 with the full scale.
03Removing duplicate up items did not materially reduce relationships with other measures and slightly improved some of them.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Participants had to walk independently with no more than a cane, so the findings may not apply to older adults who need more help with walking. The data came from a parent trial in one greater metropolitan area and included only the mGES as the gait efficacy measure. The ceiling effect may reflect the sample being higher functioning than many community-dwelling older adults, rather than a problem with the scale itself. The paper tested questionnaire structure and measurement properties. It did not test whether using a shorter scale changes clinical decisions or patient outcomes. The 10-level response scale may be difficult for participants to use consistently, and the paper did not determine whether all 10 levels are needed.
Declared interests
The supplied text does not report a conflicts of interest statement. The article is labelled as supported by NIH extramural research and non-U.S. government research.
The easy way to misread this
Do not conclude that a shorter walking confidence questionnaire improves patient care. This paper analysed questionnaire structure, not treatment effects. The 3-item version had internal consistency of 0.72 and test-retest reliability of 0.72, so it is not identical to the full scale.