Meaningful Change in Walking Speed

Evidence-based practitioners need to consider the sensitivity to change or “responsiveness” of outcome measures such as walking speed. The responsiveness of an outcome measure refers to its ability to accurately detect a change or difference when it has occurred. In this review, we first describe distribution-based and anchor-based methods and the most commonly reported indexes of responsiveness (ie, effect size, standard error of the measurement, minimal detectable change, standardized response mean, and minimal clinically important difference) for walking speed. We then summarize and synthesize the recent literature on the responsiveness of walking speed in different populations of older adults, patients with neurologic conditions (ie, stroke, Parkinson's disease, and Alzheimer's disease), and patients with orthopedic conditions (ie, hip fracture and knee osteoarthritis). In all of the studies cited, walking speed was sensitive to change over time and, when looking across studies, there is considerable agreement that meaningful change in walking speed is approximately 0.1 m/s.