Citation

Smith MG, Patritti BL. Gait Posture 2021; 91: 212-215.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.gaitpost.2021.10.041

PMID

34740058

Abstract

BACKGROUND: The Gait Assessment and Intervention Tool (GAIT) provides a valid and reliable gait quality measure for adults with stroke, however a minimal clinically important difference (MCID) is yet to be determined. RESEARCH QUESTION: What is the GAIT MCID in community dwelling adults with a stroke diagnosis? METHODS: The GAIT scores for a consecutive series of 63 adults with stroke, referred for video gait assessment within an outpatient rehabilitation program, were retrospectively identified from a gait laboratory database. Patients were classified by Functional Ambulation Category (FAC) and had walking speed measured, which classified them into one of three walking speed-based ambulatory levels (I.e. household, limited community or community ambulator). Linear regression models were fitted to assess the association between GAIT score and FAC level and GAIT score and ambulatory level. MCIDs were determined based on estimates calculated in the two models RESULTS: The FAC of patients ranged from 3 to 5. GAIT score was negatively correlated with FAC level and ambulatory level (ρ = -0.73, p < 0.001 and ρ =-0.69, p < 0.001, respectively). Pairwise comparisons from the models showed absolute mean differences between estimated GAIT scores of 10.84 (95% confidence interval 7.59-14.09) for changes from FAC level 3-4 and 12.13 (8.90-15.36) for household to limited community ambulator, and 5.90 (3.44-8.37) for changes from FAC level 4-5 and 4.39 (2.01-6.76) for limited community to community ambulator. The proposed MCID for FAC level 3 or household ambulators is 11.48, and for FAC level 4 and 5 or limited community/community ambulators is 5.19. SIGNIFICANCE: The proposed MCIDs represent real changes in gait quality measured by the GAIT for adults with stroke who exhibit lower or higher functional mobility levels. The MCIDs will assist clinicians and researchers using the tool to determine if meaningful change in gait quality has taken place for adults with stroke undergoing rehabilitation.

Language: en

Keywords

Stroke; Minimal clinically important difference; Observational gait assessment