The clinically meaningful change in physical performance scores in an elderly cohort

The aim of this study was to assess annual changes in the continuous summary physical performance score (CSPPS) and the quartile summary physical performance (QSPPS) score, evaluate how these changes relate to self-reported changes in physical function and to examine clinically meaningful changes in CSPPS and QSPPS.

This was a longitudinal study of an elderly cohort of men and women (age>65) reporting at least two domains of disability from 5 centers in the US and Europe. Subjects completed assessments of mobility, ability to perform activities of daily living (ADLs), and the physical component of the SF-36 at both baseline and at 1- year, as well as a self-report of change in function over the year. Timed physical performance tests including walking speed, repeated chair stands and balance were used to calculate QSPPS and CSPPS at baseline and one year.

Regardless of the tool used to evaluate clinical significance (ADL, SF- 36 PF, mobility disability, self-rating of physical performance) or a determination of the small meaningful change estimates based on effect size, it appears that a change of approximately 3 points in the CSPPS or 0.6 points in the QSPPS is clinically meaningful.

In this cohort with moderate to severe disability, an annual change of approximately 3 points in CSPPS and 0.6 points in QSPPS are clinically meaningful and these changes are evident at one year.