Bohannon Richard W, Gorack Walter
Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT 06269; Physical Therapy Consultants, West Hartford, CT∗.
AllStar Therapy/Apple Rehab-Farmington Valley, Plainville, CT†
PM R. 2015 Feb;7(2):130-4. doi: 10.1016/j.pmrj.2014.08.952. Epub 2014 Sep 10.
Managing in the community without accommodation requires that persons be able to walk an adequate distance. However, little information is available regarding how walking distance changes over the course of inpatient rehabilitation.
To describe, for inpatients participating in subacute rehabilitation, the distances walked without stopping at admission and discharge and to document the reliability and responsiveness of the measure.
Observational longitudinal study.
Subacute rehabilitation.
Male and female inpatients of multiple diagnostic groups who were at least 60 years old (n = 130).
Participants were asked to walk at a self-selected speed as far as they could without stopping. They walked on a 15.2-m out-and-back course for a maximum of 2 minutes upon admission, the next day, and at discharge.
The mean distances walked upon admission, the next day, and at discharge were 35.6, 39.9, and 77.0 m, respectively. Good test-retest reliability was demonstrated for the distances walked upon admission and the next day (intraclass correlation coefficient = 0.948). The distance walked increased significantly between admission and discharge (t = 22.22, P < .001). The effect size and standardized response mean for these distances were large-2.36 and 1.95, respectively. The minimum detectable change was 11.1 m. The minimal clinically important difference determined by receiver operator characteristic curve analysis ranged from 28.8 m to 43.6 m depending on the anchor used. The associated areas under the curve ranged from 0.700-0.897.
Based on our findings, we conclude that distance walked without stopping is an informative, reliable, and responsive measure of gait performance for patients undergoing subacute rehabilitation. We therefore encourage the systematic documentation of distance walked among inpatients undergoing subacute rehabilitation.
在没有住处的情况下在社区生活需要人们能够行走足够的距离。然而，关于住院康复过程中行走距离如何变化的信息却很少。
描述参与亚急性康复的住院患者入院时和出院时不停歇行走的距离，并记录该测量方法的可靠性和反应性。
观察性纵向研究。
亚急性康复机构。
多个诊断组中年龄至少60岁的男性和女性住院患者（n = 130）。
要求参与者以自我选择的速度尽可能远地不停歇行走。他们在一条15.2米的往返路线上行走，入院时、次日及出院时各行走最多2分钟。
入院时、次日及出院时的平均行走距离分别为35.6米、39.9米和77.0米。入院时和次日行走距离的重测信度良好（组内相关系数 = 0.948）。入院和出院之间行走距离显著增加（t = 22.22，P < .001）。这些距离的效应量和标准化反应均值分别为大——2.36和1.95。最小可检测变化为11.1米。根据所使用的锚定指标，通过受试者工作特征曲线分析确定的最小临床重要差异范围为28.8米至43.6米。曲线下相关面积范围为0.700 - 0.897。
基于我们的研究结果，我们得出结论，不停歇行走距离是亚急性康复患者步态表现的一种信息丰富、可靠且有反应性的测量方法。因此，我们鼓励对接受亚急性康复的住院患者的行走距离进行系统记录。
