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What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study)

  • S. KwonEmail author
  • S. Perera
  • M. Pahor
  • J. A. Katula
  • A. C. King
  • E. J. Groessl
  • S. A. Studenski
Meaningfulness in Performance Measures

Abstract

Objective

Performance measures provide important information, but the meaning of change in these measures is not well known. The purpose of this research is to 1) examine the effect of treatment assignment on the relationship between self-report and performance; 2) to estimate the magnitude of meaningful change in 400- meter walk time (400MWT), 4-meter gait speed (4MGS), and Short Physical Performance Battery (SPPB) and 3) to evaluate the effect of direction of change on estimates of magnitude.

Design

This is a secondary analysis of data from the LIFE-P study, a single blinded randomized clinical trial. Using change over one year, we applied distribution-based and anchor-based methods for self-reported mobility to estimate minimally important and substantial change in 400MWT, 4MGS and SPPB.

Setting

Four university-based clinical research sites.

Participants

Sedentary adults aged 70–89 whose SPPB scores were less than 10 and who were able to complete a 400MW at baseline (n=424).

Interventions

A structured exercise program versus health education.

Measurements

400MWT, 4MGS, SPPB.

Results

Relationships between self-report and performance measures were consistent between treatment arms. Minimally significant change estimates were 400MWT: 20–30 seconds, 4MGS: 0.03–0.05m/s and SPPB: 0.3–0.8 points. Substantial changes were 400MWT: 50–60 seconds, 4MGS: 0.08m/s, SPPB: 0.4–1.5 points. Magnitudes of change for improvement and decline were not significantly different.

Conclusions

The magnitude of clinically important change in physical performance measures is reasonably consistent using several analytic techniques and appears to be achievable in clinical trials of exercise. Due to limited power, the effect of direction of change on estimates of magnitude remains uncertain.

Key words

Aging physical performance meaningful change 

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Copyright information

© Serdi and Springer Verlag France 2009

Authors and Affiliations

  • S. Kwon
    • 1
    • 2
    • 3
    • 14
    • 15
    • 16
    Email author
  • S. Perera
    • 4
    • 5
    • 6
  • M. Pahor
    • 3
    • 7
  • J. A. Katula
    • 8
    • 9
  • A. C. King
    • 10
  • E. J. Groessl
    • 11
    • 12
  • S. A. Studenski
    • 4
    • 6
    • 13
  1. 1.College of PharmacyUniversity of FloridaGainesvilleUSA
  2. 2.Rehabilitation Outcomes Research Center NF/SG VHAGainesvilleUSA
  3. 3.Institute on Aging at University of FloridaGainesvilleUSA
  4. 4.Division of Geriatric Medicine University of PittsburghPittsburghUSA
  5. 5.Department of BiostatisticsUniversity of PittsburghPittsburghUSA
  6. 6.Institute on Aging at University of PittsburghPittsburghUSA
  7. 7.Department of Aging and Geriatric Research, College of MedicineUniversity of FloridaGainesvilleUSA
  8. 8.Wake Forest UniversityWinston-SalemUSA
  9. 9.Institute on Aging at Wake Forest UniversityWake ForestUSA
  10. 10.Stanford University School of MedicinePalo AltoUSA
  11. 11.VA San Diego Health Care SystemSan DiegoUSA
  12. 12.University of California San DiegoSan DiegoUSA
  13. 13.Geriatric Research Education and Clinical CenterDepartment of Veterans Affairs HospitalPittsburghUSA
  14. 14.University of FloridaFloridaUSA
  15. 15.South Carolina College of Pharmacy - MUSC campusCharlestonUSA
  16. 16.Department of Clinical Pharmacy and Outcome SciencesSouth Carolina College of Pharmacy - MUSC campusCharlestonUSA

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