Responsiveness of 2 procedures for measurement of temporal and spatial gait parameters in older adults

James W Youdas, Katherine B Childs, Megan L McNeil, Amy C Mueller, Christopher M Quilter, John H Hollman
PM & R: the Journal of Injury, Function, and Rehabilitation 2010, 2 (6): 537-43

OBJECTIVE: To determine the responsiveness of the GAITRite system and a stopwatch-footfall count technique for measurement of walking speed, cadence, and stride length during comfortable and fast-paced walking.

DESIGN: Criterion standard.

SETTING: Research laboratory in a physical therapy education program.

PARTICIPANTS: Twenty-four healthy volunteers (13 men, 11 women; mean age 74.5 years) without lower extremity injury or history of falls.

INTERVENTIONS: Participants walked across a GAITRite mat with embedded pressure sensors at their self-selected comfortable and fast walking speeds. Simultaneously, an examiner, using a stopwatch, recorded the elapsed time necessary to cross the mat and counted the number of complete footfalls.

MAIN OUTCOME MEASURE(S): Walking speed, cadence, and stride length were compared between the GAITRite system and the stopwatch-footfall count technique for both comfortable and fast walking speeds. Responsiveness values for each procedure were described by the 95% minimal detectable change (MDC).

RESULTS: During comfortable self-paced walking, MDC values for the stopwatch-footfall count technique ranged from 10% to 65% greater than those obtained for the GAITRite system. During fast self-paced walking MDC values for the stopwatch-footfall count technique ranged from 26% to 65% larger than those measured by the GAITRite system for the temporal and spatial gait performance parameters.

CONCLUSIONS: When measured by the GAITRite system, the 95% MDC values for temporal and spatial gait parameters of older community-dwelling adults were more responsive to change than those obtained by the stopwatch-footfall technique. Clinicians should recognize that self-selected walking speed, cadence, and stride length when obtained by an instrumented walkway must be equal to or exceed 12.6 cm/s, 8.4 steps/min, or 7 cm, respectively, for the change to be considered real change and not from measurement error.

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