Minimal Detectable Change of the Timed “Up & Go” Test and the Dynamic Gait Index in People With Parkinson Disease

Background The minimal detectable change (MDC) is the smallest amount of difference in individual scores that represents true change (beyond random measurement error). The MDCs of the Timed “Up & Go” Test (TUG) and the Dynamic Gait Index (DGI) in people with Parkinson disease (PD) are largely unknown, limiting the interpretability of the change scores of both measures. Objective The purpose of this study was to estimate the MDCs of the TUG and the DGI in people with PD. Design This investigation was a prospective cohort study. Methods Seventy-two participants were recruited from special clinics for movement disorders at a university hospital. Their mean age was 67.5 years, and 61% were men. All participants completed the TUG and the DGI assessments twice, about 14 days apart. The MDC was calculated from the standard error of measurement. The percentage MDC (MDC%) was calculated as the MDC divided by the mean of all scores for the sample. Furthermore, the intraclass correlation coefficient was used to examine the reproducibility between testing sessions (test-retest reliability). Results The respective MDC and MDC% of the TUG were 3.5 seconds and 29.8, and those of the DGI were 2.9 points and 13.3. The test-retest reliability values for the TUG and the DGI were high; the intraclass correlation coefficients were .80 and .84, respectively. Limitations The study sample was a convenience sample, and the participants had mild to moderately severe PD. Conclusions The results showed that the TUG and the DGI have generally acceptable random measurement error and test-retest reliability. These findings should help clinicians and researchers determine whether a change in an individual patient with PD is a true change.

[1]  T. Steffen,et al.  Test-Retest Reliability and Minimal Detectable Change on Balance and Ambulation Tests, the 36-Item Short-Form Health Survey, and the Unified Parkinson Disease Rating Scale in People With Parkinsonism , 2008, Physical Therapy.

[2]  A. Jette,et al.  Interpreting rehabilitation outcome measurements. , 2007, Journal of rehabilitation medicine.

[3]  H. Erdem,et al.  The effects of incremental speed-dependent treadmill training on postural instability and fear of falling in Parkinson's disease , 2007, Clinical rehabilitation.

[4]  L. Dibble,et al.  Predicting Falls In Individuals with Parkinson Disease: A Reconsideration of Clinical Balance Measures , 2006, Journal of neurologic physical therapy : JNPT.

[5]  S. Haley,et al.  Interpreting change scores of tests and measures used in physical therapy. , 2006, Physical therapy.

[6]  G. Guyatt,et al.  Commentary--goodbye M(C)ID! Hello MID, where do you come from? , 2005, Health services research.

[7]  Carolynn Patten,et al.  Reliability of gait performance tests in men and women with hemiparesis after stroke. , 2005, Journal of rehabilitation medicine.

[8]  T. Hashimoto,et al.  Static balance impairment and its change after pallidotomy in Parkinson's disease , 2004, Movement disorders : official journal of the Movement Disorder Society.

[9]  Henk J Stam,et al.  Measurement error in grip and pinch force measurements in patients with hand injuries. , 2003, Physical therapy.

[10]  Nynke Smidt,et al.  Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis. , 2002, Archives of physical medicine and rehabilitation.

[11]  P D Bezemer,et al.  REPRODUCIBILITY AND RESPONSIVENESS OF EVALUATIVE OUTCOME MEASURES , 2001, International Journal of Technology Assessment in Health Care.

[12]  W G Hopkins,et al.  Measures of Reliability in Sports Medicine and Science , 2000, Sports medicine.

[13]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[14]  G H Guyatt,et al.  Sensitivity to change of the Roland-Morris Back Pain Questionnaire: part 1. , 1998, Physical therapy.

[15]  R Iansek,et al.  Performance on clinical tests of balance in Parkinson's disease. , 1998, Physical therapy.

[16]  A. Shumway-cook,et al.  Predicting the probability for falls in community-dwelling older adults. , 1997, Physical therapy.

[17]  F. Horak,et al.  Postural inflexibility in parkinsonian subjects , 1992, Journal of the Neurological Sciences.

[18]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[19]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[20]  M. Tinetti Performance‐Oriented Assessment of Mobility Problems in Elderly Patients , 1986, Journal of the American Geriatrics Society.

[21]  B Prince,et al.  Research methodology and applied statistics. Part 2: the literature search. , 1980, Physiotherapy Canada. Physiotherapie Canada.

[22]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.

[23]  M. Hoehn,et al.  Parkinsonism , 1967, Neurology.

[24]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[25]  G. Kwakkel,et al.  Measuring gait and gait-related activities in Parkinson's patients own home environment: a reliability, responsiveness and feasibility study. , 2005, Parkinsonism & related disorders.

[26]  Marcia A. Ciol,et al.  The Effect of Cognitive Demand on Timed Up and Go Performance in Older Adults With and Without Parkinson Disease , 2003 .

[27]  R M Pickering,et al.  A community-dwelling sample of people with Parkinson's disease: characteristics of fallers and non-fallers. , 2001, Age and ageing.

[28]  G Atkinson,et al.  Statistical Methods For Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine , 1998, Sports medicine.