Meaningful Improvement in Gait Speed in Hip Fracture Recovery
Open accessAbstract
OBJECTIVES: To estimate meaningful improvements in gait speed observed during recovery from hip fracture and to evaluate the sensitivity and specificity of gait speed changes in detecting change in self‐reported mobility. DESIGN: Secondary longitudinal data analysis from two randomized controlled trials SETTING: Twelve hospitals in the Baltimore, Maryland, area. PARTICIPANTS: Two hundred seventeen women admitted with hip fracture. MEASUREMENTS: Usual gait speed and self‐reported mobility (ability to walk 1 block and climb 1 flight of stairs) measured 2 and 12 months after fracture. RESULTS: Effect size–based estimates of meaningful differences were 0.03 for small differences and 0.09 for substantial differences. Depending on the anchor (stairs vs walking) and method (mean difference vs regression), anchor‐based estimates ranged from 0.10 to 0.17 m/s for small meaningful improvements and 0.17 to 0.26 m/s for substantial meaningful improvement. Optimal gait speed cutpoints yielded low sensitivity (0.39–0.62) and specificity (0.57–0.76) for improvements in self‐reported mobility. CONCLUSION: Results from this sample of women recovering from hip fracture provide only limited support for the 0.10‐m/s cut point for substantial meaningful change previously identified in community‐dwelling older adults experiencing declines in walking abilities. Anchor‐based estimates and cut points derived from receiver operating characteristic curve analysis suggest that greater improvements in gait speed may be required for substantial perceived mobility improvement in female hip fracture patients. Furthermore, gait speed change performed poorly in discriminating change in self‐reported mobility. Estimates of meaningful change in gait speed may differ based on the direction of change (improvement vs decline) or between patient populations.
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The sample size was calculated to provide 80% power to detect a difference of 0.10 m/s (MCID) between active groups and placebo on CFB in 400MWT GS at 6 months, requiring 64 subjects/group (231 total with 20% dropout).
“This led to recalculation with an expected improvement in BIO101‐treated group of 0.05 m/s as CFB, a power of 80% to detect a substantial difference of 0.10 m/s (minimal clinically important difference—MCID) [20, 21] between active groups and placebo on CFB in 400MWT GS at 6 months; 64 subjects/group were needed, giving a sample size of 231 subjects with 20% provision for premature withdrawals or”
From BIO101 in Sarcopenic Seniors at Risk of Mobility Disability: Results of a Double-Blind Randomised Interventional Phase 2b Trial (2025) · cites this paper as [21]
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- Authors
- Alley, D. E., Hicks, G. E., Shardell, M., Hawkes, W., Miller, R., Craik, R. L., Mangione, K. K., Orwig, D., Hochberg, M., Resnick, B., & Magaziner, J.
- Affiliations
- University of Maryland, Baltimore (US)
- ORCID
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2011-08-24
- Volume
- 59
- Issue
- 9
- Pages
- 1650-1657
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3230716
- OpenAlex
- W1607549895
- Cited by
- 54
- References
- 39
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 5 · 2015: 5 · 2014: 8 · 2013: 5 · 2012: 3
- FWCI
- 5.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Amgen
- Eli Lilly and Company
- National Institutes of Health
- National Institute on Aging (R01AG017082, K23AG027746, R37 AG 09901, R01 AG18668, R01AG018668, K25AG034216, R01AG17082, R37AG009901, K25AG03421, P30AG028747)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12HD043489)
- Topics
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- 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
- Keywords
- hip fracture, walking speed, meaningful change, self-reported mobility, women, postoperative recovery, cut points, sensitivity and specificity, anchor-based estimation, effect size, walking ability, older adults
- MeSH terms
- Aged, Aged, 80 and over, Female, Gait, Hip Fractures, Humans, Walking, Recovery of Function
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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