What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study)
Open accessAbstract
OBJECTIVE: Performance measures provide important information, but the meaning of change in these measures is not well known. The purpose of this research is to 1) examine the effect of treatment assignment on the relationship between self-report and performance; 2) to estimate the magnitude of meaningful change in 400-meter walk time (400MWT), 4-meter gait speed (4MGS), and Short Physical Performance Battery (SPPB) and 3) to evaluate the effect of direction of change on estimates of magnitude. DESIGN: This is a secondary analysis of data from the LIFE-P study, a single blinded randomized clinical trial. Using change over one year, we applied distribution-based and anchor-based methods for self-reported mobility to estimate minimally important and substantial change in 400MWT, 4MGS and SPPB. SETTING: Four university-based clinical research sites. PARTICIPANTS: Sedentary adults aged 70-89 whose SPPB scores were less than 10 and who were able to complete a 400MW at baseline (n=424). INTERVENTIONS: A structured exercise program versus health education. MEASUREMENTS: 400MWT, 4MGS, SPPB. RESULTS: Relationships between self-report and performance measures were consistent between treatment arms. Minimally significant change estimates were 400MWT: 20-30 seconds, 4MGS: 0.03-0.05m/s and SPPB: 0.3 - 0.8 points. Substantial changes were 400MWT: 50-60 seconds, 4MGS: 0.08m/s, SPPB: 0.4 - 1.5 points. Magnitudes of change for improvement and decline were not significantly different. CONCLUSIONS: The magnitude of clinically important change in physical performance measures is reasonably consistent using several analytic techniques and appears to be achievable in clinical trials of exercise. Due to limited power, the effect of direction of change on estimates of magnitude remains uncertain.
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Minimally significant changes on the Short Physical Performance Battery range from 0.3 to 0.8 points.
“Minimally significant changes for SPPB is 0.3 to 0.8 points [37, 38].”
From Pilot study of a telehealth perioperative physical activity intervention for older adults with cancer and their caregivers (2020) · cites this paper as [38]
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- Authors
- Kwon, S., Perera, S., Pahor, M., Katula, J. A., King, A. C., Groessl, E. J., & Studenski, S. A.
- Affiliations
- University of Florida (US)
- University of Pittsburgh (US)
- Wake Forest University (US)
- Stanford Medicine (US)
- University of California San Diego (US)
- Corresponding author
- Kwon, S.
- Venue
- The Journal of nutrition, health and aging
- Publisher
- Elsevier BV
- Published
- 2009-06
- Volume
- 13
- Issue
- 6
- Pages
- 538-544
- ISSN
- 1279-7707 (ISSN-L)
- PMC
- PMC3100159
- OpenAlex
- W2073862763
- Cited by
- 494
- References
- 29
- Citations by year
- 2026: 24 · 2025: 33 · 2024: 47 · 2023: 32 · 2022: 35 · 2021: 34 · 2020: 39 · 2019: 29 · 2018: 29 · 2017: 38 · 2016: 29 · 2015: 29 · 2014: 23 · 2013: 25 · 2012: 22
- FWCI
- 40.74
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The journal of nutrition health & aging (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Agriculture (58‐1950‐4‐401)
- Eli Lilly and Company
- Yale University
- Teva Pharmaceutical Industries
- Wake Forest University (P30 AG21332, 1P30AG21332, P30 AG024827)
- University of Pittsburgh (P30-AG024827)
- National Institutes of Health (UL1TR000064, 58-1950-4-401, #UO1 AG22376, AG024827, AG028740, 1 P30 AG21332)
- University of California, Los Angeles
- University of California, San Diego
- Geriatric Research Education and Clinical Center
- National Institute on Aging (1-P30-AG21332, U01AG22376, U01AG022376, K24AG021507, AG 024827, UO1 AG22376, AG028740, AG22376, P30AG-21332, P30AG024827, P30AG028740, P30AG021332)
- National Center for Research Resources (UL1RR029890)
- NIH Clinical Center
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- minimally important change, substantial change, physical performance, older adults, sedentary older adults, walking speed, Short Physical Performance Battery, self-reported mobility, direction of change, exercise intervention
- MeSH terms
- Aged, Aged, 80 and over, Aging, Disability Evaluation, Exercise Therapy, Health Education, Humans, Physical Fitness, Research Design, Self Disclosure, Single-Blind Method, Walking
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