The minimal clinically important difference of six-minute walk in Asian older adults

Abstract

BackgroundRehabilitation interventions promote functional recovery among frail older adults and little is known about the clinical significance of physical outcome measure changes. The purpose of our study is to examine the minimal clinically important difference (MCID) for the 6-minute walk distance (6MWD) among frail Asian older adults.MethodsData from the “Evaluation of the Frails’ Fall Efficacy by Comparing Treatments” study were analyzed. Distribution-based and anchor-based methods were used to estimate the MCID of the 6MWD. Participants who completed the trial rated their perceived change of overall health on the Global Rating of Change (GROC) scale. The receiver operating characteristic curve (ROC) was used to analyze the sensitivity and specificity of the cut-off values of 6MWD (in meters) for GROC rating of “a little bit better” (+2), based on feedback from participants.ResultsThe mean (SD) change in 6MWD was 37.3(46.2) m among those who perceived a change (GROC ≥ 2), while those who did not was 9.3(18.2) m post-intervention (P = 0.011). From the anchor-based method, the MCID value for the 6MWD was 17.8 m (sensitivity 56.7% and specificity 83.3%) while distribution-based method estimated 12.9 m.ConclusionThe MCID estimate for 6MWD was 17.8 m in the moderately frail Asian older adults with a fear of falling. The results will aid the clinicians in goal setting for this patient population.Trial registrationAustralian New Zealand Clinical Trials Registry number: ACTRN12610000576022

Impact of Adapted Physical Activity and Therapeutic Patient Education on Functioning and Quality of Life in Patients With Postacute Strokes

“…A distance walked of 18 to 20 m was determined to be the MCID for fragile, elderly patients undergoing rehabilitation interventions. 40,41 Our results add to the existing evidence from a systematic review of trials involving community-dwelling survivors of strokes that The 4-month assessment corresponds to 2 months after intervention in the experimental group. Data are presented as mean ± standard deviation.…”

Minimal clinically important difference for change in 6‐minute walk test distance of adults with pathology: a systematic review

“…Database searches, handsearches, and consultation with an expert yielded 39 potentially relevant articles. After reviews of their titles, abstracts, and full text, 6 were found appropriate for inclusion in our review . Table summarizes the studies.…”

“…After reviews of their titles, abstracts, and full text, 6 were found appropriate for inclusion in our review. [7][8][9][10][11][12] (Table 3). comparisons with some other studies, the scale has been used previously and allows for a focus on key elements of the MCID.…”

“…The anchor‐based MCID is well established as an indicator of such change, and ROC analysis is considered to be a superior approach for determining MCIDs . Although numerous MCIDs for the 6MWT have been proposed, we believe that ours is the first systematic review of MCIDs for the 6MWT determined by ROC analysis. Although our review was focused on MCIDs so determined, it is validating that MCIDs calculated by others who used regression analysis (14.0‐35.4 m) are within the range we reported.…”

“…Summary of studies describing the minimal clinically important difference for 6-minute walk test distance Although numerous MCIDs for the 6MWT have been proposed,[7][8][9][10][11][12][13][14][15][16] we believe that ours is the first sys-tematic review of MCIDs for the 6MWT determined by ROC analysis. Although our review was focused on MCIDs so determined, it is validating that MCIDs calculated by others who used regression analysis (14.0-35.4 m) 13,14 are within the range we reported.…”