Gait speed self-prediction accuracy for people with neurological conditions in inpatient rehabilitation

Introduction: A component of engaging in functional motor tasks is the ability to assess one's own motor performance in relationship to that task. Objective: The primary purpose of this exploratory study is to investigate gait speed prediction accuracy for patients with neurological conditions participating in an Inpatient Rehabilitation (IPR) program. The secondary purpose was to evaluate what factors contributed to patient judgment error. Methods: Nineteen subjects with a neurologic diagnosis who were admitted to an IPR unit were asked to predict their gait speed prior to execution of the 10-meter walk test. Data was analyzed to compare predicted versus actual gait speeds. Results: Strong Pearson correlations (r) between actual and predicted gait speeds were found at time 1 (r = 0.90; 95%CI = 0.83, 0.96; p<.001), time 2 (r = 0.87; 95%CI = 0.74, 0.96; p<.001), and time 3 (r = 0.91; 95% CI = 0.82, 0.97; p<.001). Ninety-five percent limits of agreement (LOA) were calculated to be -0.07, 0.30 m/s at time 1; -0.21, 0.37 m/s at time 2; and -0.22, 0.34 at time 3. Conclusions: Despite the strong correlations, there appears to be less certainty surrounding the relationship between actual gait speed and predicted gait speed when examining the limits of agreement. In general, subjects ambulated faster than they predicted, underestimating their actual performance. A mismatch between predicted gait speed and actual gait speed performance can have clinical implications.