What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study)
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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.
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.
Four university-based clinical research sites.
Sedentary adults aged 70–89 whose SPPB scores were less than 10 and who were able to complete a 400MW at baseline (n=424).
A structured exercise program versus health education.
400MWT, 4MGS, SPPB.
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.
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 wordsAging physical performance meaningful change
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- 6.Arai T, Obuchi S, Inaba Y, Nagasawa H, Shiba Y, Watanabe S et al. The effects of short-term exercise intervention on falls self-efficacy and the relationship between changes in physical function and falls self-efficacy in Japanese older people: a randomized controlled trial. Am J Phys Med Rehabil 2007;86(2):133–141.PubMedCrossRefGoogle Scholar
- 9.Sullivan KJ, Brown DA, Klassen T, Mulroy S, Ge T, Azen SP et al. Effects of Task-Specific Locomotor and Strength Training in Adults Who Were Ambulatory After Stroke: Results of the STEPS Randomized Clinical Trial. Phys Ther 2007.Google Scholar
- 13.Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. The journals of gerontology 2000;55(4):M221–M231.PubMedGoogle Scholar
- 15.Pahor M, Blair SN, Espeland M, Fielding R, Gill TM, Guralnik JM et al. Effects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study. The journals of gerontology 2006;61(11):1157–1165.PubMedGoogle Scholar
- 19.Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum; 1988.Google Scholar