Is training speed an accurate predictor of who attains a minimal clinically important difference in the six-minute walk test in people with chronic stroke?
Kiersten M McCartney, Pierce Boyne, Ryan T Pohlig and 2 others
PMID 40490678WHAT IT FOUND
Average treadmill speed did not predict which people with chronic stroke achieved a clinically meaningful improvement in the six-minute walk test.
Clinicians cannot rely on training speed alone to determine who will respond to high-intensity walking interventions.
Key findings
01Average training speed had poor, non-significant accuracy in predicting whether participants achieved a small (≥20m) or moderate (≥50m) clinically important change in the six-minute walk test.
02While 71% of the sample achieved a small change and 38% achieved a moderate change in walking endurance, no specific threshold training speed could be identified to predict these outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The analysis dichotomized continuous outcome data, which results in a loss of information. There is no consensus on the optimal method for determining minimal clinically important differences for the six-minute walk test in stroke populations. The study only examined average training speed as a predictor, ignoring other potential factors like session frequency, total volume, or individual baseline capacity.
Declared interests
The funders played no role in the design, conduct, or reporting of this study, and the authors declared no competing interests.
The easy way to misread this
Do not assume that increasing treadmill speed will automatically lead to a clinically important improvement in walking endurance. The study found that speed alone was a poor predictor of response, meaning some patients who walk slowly may still improve significantly, while those who walk fast may not meet the threshold for meaningful change.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →