Document Detail

Meaningful change and responsiveness in common physical performance measures in older adults.
MedLine Citation:
PMID:  16696738     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To estimate the magnitude of small meaningful and substantial individual change in physical performance measures and evaluate their responsiveness. DESIGN: Secondary data analyses using distribution- and anchor-based methods to determine meaningful change. SETTING: Secondary analysis of data from an observational study and clinical trials of community-dwelling older people and subacute stroke survivors. PARTICIPANTS: Older adults with mobility disabilities in a strength training trial (n=100), subacute stroke survivors in an intervention trial (n=100), and a prospective cohort of community-dwelling older people (n=492). MEASUREMENTS: Gait speed, Short Physical Performance Battery (SPPB), 6-minute-walk distance (6MWD), and self-reported mobility. RESULTS: Most small meaningful change estimates ranged from 0.04 to 0.06 m/s for gait speed, 0.27 to 0.55 points for SPPB, and 19 to 22 m for 6MWD. Most substantial change estimates ranged from 0.08 to 0.14 m/s for gait speed, 0.99 to 1.34 points for SPPB, and 47 to 49 m for 6MWD. Based on responsiveness indices, per-group sample sizes for clinical trials ranged from 13 to 42 for substantial change and 71 to 161 for small meaningful change. CONCLUSION: Best initial estimates of small meaningful change are near 0.05 m/s for gait speed, 0.5 points for SPPB, and 20 m for 6MWD and of substantial change are near 0.10 m/s for gait speed, 1.0 point for SPPB, and 50 m for 6MWD. For clinical use, substantial change in these measures and small change in gait speed and 6MWD, but not SPPB, are detectable. For research use, these measures yield feasible sample sizes for detecting meaningful change.
Subashan Perera; Samir H Mody; Richard C Woodman; Stephanie A Studenski
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  54     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-15     Completed Date:  2006-06-13     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  743-9     Citation Subset:  IM    
Division of Geriatric Medicine and Department of Biostatistics, Univeristy of Pittsburgh, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
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MeSH Terms
Aged, 80 and over
Cohort Studies
Exercise Test
Gait / physiology*
Middle Aged
Mobility Limitation*
Psychomotor Performance / physiology*
Recovery of Function / physiology*
Stroke / physiopathology*,  rehabilitation
Walking / physiology*
Grant Support
K07 AG 023641/AG/NIA NIH HHS; P30 AG 014827/AG/NIA NIH HHS; P60 AG 14635/AG/NIA NIH HHS

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