Minimal clinically important differences of spatiotemporal gait variables in Parkinson disease.
Sidney T Baudendistel, Allison M Haussler, Kerri S Rawson and 1 others
PMID 38150946WHAT IT FOUND
In Parkinson disease, specific gait changes mark clinically important differences: 8.2cm/s for speed, 3.6cm for step length, and about 0.7% for variability.
These values help determine if treatment effects are real or just measurement noise.
Key findings
01Triangulated minimal clinically important differences were established for four gait variables: velocity at 8.2cm/s, step length at 3.6cm, CV step length at 0.7%, and CV step time at 0.67%.
02These values were derived from a cross-sectional analysis of 382 ambulatory individuals with Parkinson disease who were mostly in modified Hoehn and Yahr stages 2 to 2.5.
03Other variables like step width and asymmetry could not be triangulated because they showed no significant association with the clinical anchors used.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The MCIDs are derived from a cross-sectional, between-person analysis, which may underestimate actual within-person longitudinal change. The sample was predominantly in modified Hoehn and Yahr stages 2 to 2.5, limiting applicability to very early or very late disease stages. Individuals using assistive devices or those with deep brain stimulation were excluded. Many participants did not meet the recommended 30-step minimum for measuring gait variability, potentially affecting the reliability of variability MCIDs. The values are specific to the GAITRite instrumented walkway and may not transfer directly to less accurate systems like accelerometry.
Declared interests
The study was supported by the National Institutes of Health (N.I.H., Extramural). No other conflicts of interest were reported.
The easy way to misread this
Do not apply these MCID values to patients using assistive devices or those with deep brain stimulation, as they were excluded. Also, do not assume these values are identical for other measurement systems like accelerometers, as the accuracy of the GAITRite walkway was critical to these calculations.