scholarly journals Determining Meaningful Changes in Gait Speed After Hip Fracture

2006 ◽  
Vol 86 (6) ◽  
pp. 809-816 ◽  
Author(s):  
Kerstin M Palombaro ◽  
Rebecca L Craik ◽  
Kathleen K Mangione ◽  
James D Tomlinson
Keyword(s):  
Hip Fracture ◽  
Expert Opinion ◽  
Roc Curve ◽  
Gait Speed ◽  
Operating Characteristic ◽  
Important Change ◽  
Minimal Detectable Change ◽  
Older Subjects ◽  
Clinically Important Change ◽  
Clinical Expert

AbstractBackground and Purpose. Older subjects after hip fracture walk more slowly than age-matched peers. The extent to which they walk more slowly is difficult to define because the standard error of the measure (SEM), sensitivity to change, and clinically important change have not been reported for gait speed. The purposes of this study were to quantify the SEM for habitual and fast gait speeds among older subjects after hip fracture, to define the minimal detectable change (MDC), and to estimate the minimal clinically important difference (MCID) for habitual gait speed. Subjects. A sample of 92 subjects after hip fracture was drawn from 3 studies that collected gait speed data. Methods. An estimate of the MDC was determined by use of the SEM. The MCID was determined from expert opinion and from a receiver operating characteristic (ROC) curve. Results. The SEM and the MDC were 0.08 m/s and 0.10 m/s for habitual speed and fast speed, respectively. Both methods of MCID estimation identified 0.10 m/s as a meaningful change in habitual gait speed. Discussion and Conclusion. The estimated MCID for gait speed of 0.10 m/s was supported by clinical expert opinion and the cutoff point of the ROC curve. [Palombaro KM, Craik RL, Mangione KK, Tomlinson JD. Determining meaningful changes in gait speed after hip fracture.Phys Ther. 2006; 86:809–816.]

scholarly journals Case Report: Combining Dalfampridine with Multicomponent Exercise and Gait Training in a Person with Multiple Sclerosis

2018 ◽  
Vol 20 (5) ◽  
pp. 238-243
Author(s):  
Prudence Plummer ◽  
Corinne J. Bohling ◽  
L. Ellese Nickles ◽  
Alexis A. Williams ◽  
Amy Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Dual Task ◽  
Gait Speed ◽  
Gait Training ◽  
Important Change ◽  
Relapsing Remitting ◽  
History Of ◽  
Task Conditions ◽  
Clinically Important Change

Abstract Background: Dalfampridine extended release (D-ER) improves gait speed in some people with multiple sclerosis (MS), but many patients who take D-ER demonstrate only small improvements of questionable clinical significance. Physical therapy (PT) may augment the treatment effects of D-ER on the nervous system and improve clinical outcomes. This case report describes the successful use of D-ER combined with multicomponent PT in a patient who did not have a clinically important change in gait speed with D-ER alone. Methods: A 59-year-old woman with a 6-year history of relapsing-remitting MS was prescribed D-ER by her neurologist. After 3 weeks of D-ER therapy (10 mg twice daily), she demonstrated only a 7.1% improvement in the Timed 25-Foot Walk test. She then commenced PT consisting of two 40-minute sessions per week for 6 weeks while continuing D-ER therapy. Training focused on gait, balance, coordination, functional strengthening, and dual-task performance. Results: After 6 weeks of D-ER + PT, she had a further 14.6% improvement in Timed 25-Foot Walk gait speed, for a total improvement of 20.7%, which elevated her above the clinically meaningful threshold of 20%. Similar patterns of improvement were also observed for self-selected gait speed in single- and dual-task conditions. Improvements in fast and dual-task gait speed were retained 3 weeks later. Conclusions: For this patient, combining PT with D-ER therapy improved gait speed more than the use of D-ER alone. Further investigation of D-ER + PT or PT as an alternative to D-ER in patients with submeaningful medication response is warranted.

Estimating Clinically Important Change in Gait Speed in People With Stroke Undergoing Outpatient Rehabilitation

2011 ◽  
Vol 35 (2) ◽  
pp. 82-89 ◽  
Author(s):  
George D. Fulk ◽  
Miriam Ludwig ◽  
Kari Dunning ◽  
Sue Golden ◽  
Pierce Boyne ◽  
...  
Keyword(s):  
Gait Speed ◽  
Important Change ◽  
Outpatient Rehabilitation ◽  
Clinically Important Change

Community walking can be assessed using a 10-metre timed walk test

2011 ◽  
Vol 17 (8) ◽  
pp. 980-990 ◽  
Author(s):  
JCE Kempen ◽  
V de Groot ◽  
DL Knol ◽  
CH Polman ◽  
GJ Lankhorst ◽  
...  
Keyword(s):  
Gait Speed ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Strong Relationship ◽  
Important Change ◽  
Gait Velocity ◽  
Walk Test ◽  
Disability Status ◽  
Minimally Important Change ◽  
Modified Functional

Background: A decline in mobility is a common feature of multiple sclerosis (MS). Community walking scales are used to categorize patients in their ability to move independently. The first purpose of this study was to determine which specific gait speed corresponded with the categories of the Modified Functional Walking Categories (MFWC). The second purpose was to determine the Minimally Important Change (MIC) in absolute gait speed using the MFWC and Expanded Disability Status Scale (EDSS) as external criteria. Method: MS patients were measured six times in 6 years. Gait velocity was measured with the 10-metre timed walk test (10-m TWT), the severity of MS was determined with the EDSS, and community walking was assessed with the MFWC. For each category of the MFWC, Receiver Operating Characteristic (ROC) curves were used to find the best possible cut-off point on the 10-m TWT. The MIC in absolute gait speed was determined using a change of one category on the MFWC or one point on the EDSS. Results: A strong relationship was found between gait speed and the MFWC; all areas under the ROC curves (AUCs) were between 0.74 and 0.86. The MIC in absolute gait speed could not be determined, because the AUCs were below the threshold of 0.70 and changes in gait speed were small. Conclusions: Gait speed is related to community walking, but an MIC in absolute gait speed could not be determined using a minimally important change on the MFWC or the EDSS as external criteria.

The reliability, precision and clinically meaningful change of walking assessments in multiple sclerosis

2013 ◽  
Vol 19 (13) ◽  
pp. 1784-1791 ◽  
Author(s):  
Yvonne C Learmonth ◽  
Deirdre D Dlugonski ◽  
Lara A Pilutti ◽  
Brian M Sandroff ◽  
Robert W Motl
Keyword(s):  
Multiple Sclerosis ◽  
Intraclass Correlation ◽  
Important Change ◽  
Minimal Detectable Change ◽  
Walking Aids ◽  
Clinically Important Change ◽  
Standard Error Of Measurement ◽  
Disability Level ◽  
Minute Walk ◽  
Error Of Measurement

Background: Assessing walking impairment in those with multiple sclerosis (MS) is common, however little is known about the reliability, precision and clinically important change of walking outcomes. Objective: The purpose of this study was to determine the reliability, precision and clinically important change of the Timed 25-Foot Walk (T25FW), Six-Minute Walk (6MW), Multiple Sclerosis Walking Scale-12 (MSWS-12) and accelerometry. Methods: Data were collected from 82 persons with MS at two time points, six months apart. Analyses were undertaken for the whole sample and stratified based on disability level and usage of walking aids. Intraclass correlation coefficient (ICC) analyses established reliability: standard error of measurement (SEM) and coefficient of variation (CV) determined precision; and minimal detectable change (MDC) defined clinically important change. Results: All outcome measures were reliable with precision and MDC varying between measures in the whole sample: T25FW: ICC=0.991; SEM=1 s; CV=6.2%; MDC=2.7 s (36%), 6MW: ICC=0.959; SEM=32 m; CV=6.2%; MDC=88 m (20%), MSWS-12: ICC=0.927; SEM=8; CV=27%; MDC=22 (53%), accelerometry counts/day: ICC=0.883; SEM=28450; CV=17%; MDC=78860 (52%), accelerometry steps/day: ICC=0.907; SEM=726; CV=16%; MDC=2011 (45%). Variation in these estimates was seen based on disability level and walking aid. Conclusion: The reliability of these outcomes is good and falls within acceptable ranges. Precision and clinically important change estimates provide guidelines for interpreting these outcomes in clinical and research settings.

scholarly journals Statistical Assessment of Discrimination Capabilities of a Fractional Calculus Based Image Watermarking System for Gaussian Watermarks

Entropy ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. 255
Author(s):  
Mario Gonzalez-Lee ◽  
Hector Vazquez-Leal ◽  
Luis J. Morales-Mendoza ◽  
Mariko Nakano-Miyatake ◽  
Hector Perez-Meana ◽  
...  
Keyword(s):  
Fractional Calculus ◽  
Roc Curve ◽  
Gaussian Noise ◽  
False Positive ◽  
Operating Characteristic ◽  
Image Watermarking ◽  
Area Under The Curve ◽  
Statistical Assessment ◽  
Watermarking Scheme ◽  
Fractional Equation

In this paper, we explore the advantages of a fractional calculus based watermarking system for detecting Gaussian watermarks. To reach this goal, we selected a typical watermarking scheme and replaced the detection equation set by another set of equations derived from fractional calculus principles; then, we carried out a statistical assessment of the performance of both schemes by analyzing the Receiver Operating Characteristic (ROC) curve and the False Positive Percentage (FPP) when they are used to detect Gaussian watermarks. The results show that the ROC of a fractional equation based scheme has 48.3% more Area Under the Curve (AUC) and a False Positives Percentage median of 0.2% whilst the selected typical watermarking scheme has 3%. In addition, the experimental results suggest that the target applications of fractional schemes for detecting Gaussian watermarks are as a semi-fragile image watermarking systems robust to Gaussian noise.

scholarly journals Presepsin values and prognostic nutritional index predict mortality in intensive care unit patients with sepsis: a pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuichiro Shimoyama ◽  
Osamu Umegaki ◽  
Noriko Kadono ◽  
Toshiaki Minami
Keyword(s):  
Multivariate Analysis ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Prognostic Nutritional Index ◽  
Early Mortality ◽  
Curve Analysis ◽  
Rank Test ◽  
Roc Curve Analysis ◽  
Log Rank Test ◽  
Nutritional Index

Abstract Objective Sepsis is a major cause of mortality for critically ill patients. This study aimed to determine whether presepsin values can predict mortality in patients with sepsis. Results Receiver operating characteristic (ROC) curve analysis, Log-rank test, and multivariate analysis identified presepsin values and Prognostic Nutritional Index as predictors of mortality in sepsis patients. Presepsin value on Day 1 was a predictor of early mortality, i.e., death within 7 days of ICU admission; ROC curve analysis revealed an AUC of 0.84, sensitivity of 89%, and specificity of 77%; and multivariate analysis showed an OR of 1.0007, with a 95%CI of 1.0001–1.0013 (p = 0.0320).

Wideband Absorbance in Ears with Retraction Pockets and Cholesteatomas: A Preliminary Study

2021 ◽  
Author(s):  
Sreedevi Aithal ◽  
Venkatesh Aithal ◽  
Joseph Kei ◽  
Shane Anderson
Keyword(s):  
Prospective Study ◽  
Roc Curve ◽  
Operating Characteristic ◽  
Peak Pressure ◽  
Clinical Sample ◽  
Ambient Pressure ◽  
Control Group ◽  
Retraction Pockets ◽  
Preliminary Study ◽  
The Difference

Abstract Objectives The objective of this study was to describe wideband absorbance (WBA) findings in patients with cholesteatomas and retraction pockets (RPs). Design In this prospective study, tympanometry, audiometry, and wideband tympanometry (WBT) were performed on 27 ears with an RP (eight with epitympanic RP and 19 ears with mesotympanic RP), 39 ears with a cholesteatoma (23 ears with epitympanic and 16 ears with mesotympanic cholesteatomas [MCs]), and 49 healthy ears serving as controls. Results Mean WBA at ambient pressure (WBAamb) of both experimental groups was reduced significantly between 0.8 and 5 kHz relative to the control group. The difference between mean WBAamb and mean WBA at tympanometric peak pressure (WBATPP) was greater for the RP (0.12–0.16 between 0.5 and 1.5 kHz) than for the cholesteatoma group (0.03–0.11 between 0.6 and 3 kHz). Mean WBAamb of both epitympanic RP (ERP) and epitympanic cholesteatoma (EC) subgroups was significantly lower than that of the control group. Mean WBATPP of the ERP subgroup attained normal levels as per the control group, while mean WBATPP of EC subgroup was significantly lower than that of the control group at 0.8 to 1.5 kHz and 4 to 5 kHz. In contrast, both mesotympanic RP and MC subgroups demonstrated similar mean WBAamb and WBATPP values. No significant differences in WBAamb and WBATPP results between the RP and cholesteatomas groups were observed. Receiver operating characteristic (ROC) analyses indicated that the area under the ROC curve for distinguishing between the RP and cholesteatomas groups ranged from 0.44 to 0.60, indicating low accuracy in separating the two groups. Conclusion While it is not possible to distinguish between the RP and cholesteatomas groups based on the WBAamb and WBATPP results, it is potentially feasible to differentiate between the EC and ERP conditions. Further study using a large clinical sample is recommended to determine the sensitivity and specificity of the WBA test to identify the EC and ERP conditions.

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