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The Wisconsin gait scale - The minimal clinically important difference.

Agnieszka Guzik1, Mariusz Drużbicki1, Andżelina Wolan-Nieroda1

  • 1Institute of Physiotherapy, Medical Faculty, University of Rzeszow, Hoffmanowej 25, 35-310 Rzeszów, Poland; Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Warzywna 1a, 35-310 Rzeszów, Poland.

Gait & Posture
|January 2, 2019
PubMed
Summary

The Wisconsin Gait Scale (WGS) minimal clinically important difference (MCID) was determined to be 2.25 points. This finding helps clinicians assess meaningful gait quality improvements in stroke survivors.

Keywords:
GaitHemiplegiaMinimal clinically important differenceStroke

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Area of Science:

  • Rehabilitation Medicine
  • Neurology
  • Biostatistics

Background:

  • The Wisconsin Gait Scale (WGS) evaluates gait quality in hemiplegic stroke survivors.
  • It assesses 14 spatiotemporal and kinematic parameters across gait phases.
  • A clinically meaningful change threshold for WGS scores was previously undetermined.

Purpose of the Study:

  • To define the minimal clinically important difference (MCID) for the Wisconsin Gait Scale (WGS).

Main Methods:

  • Utilized four methods to determine WGS MCID in 50 stroke participants: anchor-based, distribution-based, linear regression, and ROC curve analysis.
  • Anchor-based study yielded an MCID estimate of 1.9 points.
  • Distribution-based analysis provided an MCID estimate of 0.3 points.

Main Results:

  • Linear regression indicated a 1.21-point WGS change per Barthel Index (BI) point, translating to a 2.25-point WGS change for a 1.85-point BI change.
  • ROC curve analysis identified 1 point of WGS change as the optimal cut-off.
  • The largest MCID estimate, 2.25 points, was selected as the definitive MCID.

Conclusions:

  • The minimal clinically important difference (MCID) for the Wisconsin Gait Scale (WGS) is established at 2.25 points.
  • This value aids clinicians and researchers in interpreting the clinical significance of WGS score changes in stroke patients.