INVESTIGATION OF THE MCID FOR COMFORTABLE WALKING SPEED IN FEMORAL NECK FRACTURE CASES: ONE-MONTH ASSESSMENT POST-ADMISSION TO A REHABILITATION WARD

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Yuki Uetani, Tomomi Tkakimoto, Toshihide Okazaki, Kensuke Suzuki, Hikaru Yanagida, Shota Maruta
Purpose:

This study aims to identify the MCID for comfortable walking speed in femoral neck fracture patients in a convalescent ward to support rehabilitation outcomes.

Methods:

We included 38 femoral neck fracture patients admitted to our convalescent ward from April 2023 to April 2024, following them until discharge. Patients with a Functional Independence Measure (FIM) transfer score of 1 or 7 at admission were excluded. Referring to Arcolin et al., who reported an MCID of 22 points for motor FIM in similar patients one month post-operatively, we categorized patients into two groups: "good" (≥22-point improvement in motor FIM) and "poor" (22-point improvement). The motor component of the FIM and the 10-meter comfortable walking test were assessed at the time of admission and reassessed one-month post-admission. Multiple evaluators conducted the assessments, and the inter-rater reliability was confirmed, ensuring the robustness and consistency of the evaluation outcomes. We analyzed the correlation between changes in motor FIM and walking speed using Spearman's rank correlation. The MCID was defined as the cutoff value of comfortable walking speed determined by the receiver-operating-characteristic (ROC) curve with the availability of 22-point FIM improvement as the dependent variable and the amount of change in comfortable walking speed as the indeendent variable.

Results:

Of the 38 patients, 10 were in the good group and 28 in the poor group. The good group showed improvements of 26.6 ± 3.6 points in motor FIM and 0.15 ± 0.07 m/s in walking speed, while the poor group showed improvements of 19.5 ± 4.2 points in motor FIM and 0.09 ± 0.06 m/s. A moderate positive correlation was found between changes in motor FIM and walking speed (r = 0.67). The MCID for comfortable walking speed was calculated as 0.08 m/s (sensitivity 80%, specificity 60%) with an AUC of 0.70, 95%CI:0.78-0.89indicating valid predictive value.

Conclusion(s):

The MCID for comfortable walking speed in femoral neck fracture patients one month after admission to a convalescent ward is 0.08 m/s. Exceeding this threshold indicates a significant improvement in motor FIM, supporting its use as a key indicator in evaluating physical therapy outcomes.

Implications:

Patients who improve their comfortable walking speed by more than 0.08 m/s may in the recovery phase may correlate with meaningful motor FIM improvements, aiding in decision-making for rehabilitation therapies.

Funding acknowledgements:
This work was unfunded
Keywords:
Femoral Neck Fracture
Comfortable Walking Speed
MCID
Primary topic:
Orthopaedics
Second topic:
Older people
Third topic:
Orthopaedics
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Nerima takanodai hospital Ethics Review Committee
Provide the ethics approval number:
25-1
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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