Measurement of Distance Walked by Older Adults Participating in Subacute Rehabilitation

Abstract

BackgroundManaging 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. ObjectivesTo 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. DesignObservational longitudinal study. SettingSubacute rehabilitation. PatientsMale and female inpatients of multiple diagnostic groups who were at least 60 years old (n = 130). MethodsParticipants 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. ResultsThe 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. ConclusionsBased 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.