Validation of usual walking speed as an indicator of postoperative recovery and estimation of its minimal clinically important difference in patients with colorectal cancer undergoing radical surgery

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PURPOSE: This study aimed to ascertain the validity of usual walking speed (UWS) as a postoperative recovery indicator and investigate the minimal clinically important difference (MCID) in UWS before to 1 week after radical surgery in patients with colorectal cancer (CRC). METHODS: To ascertain the concurrent validity (based on the hypothesis, test if there is a difference in the measured results in a population with a certain characteristic) of UWS as an indicator of postoperative recovery, the correlation coefficient between UWS and 6-minute walk distance (6MWD) changes was calculated. To assess the construct validity, the effect size (ES) was calculated for the difference between groups of UWS and 6MWD changes by comparing between patients with and without the following characteristics: older age, open surgery, postoperative complications, and delayed postoperative ambulation. To evaluate the responsiveness of UWS, ES and standardized response mean (SRM), for the difference within groups, were calculated. The MCID of UWS was calculated using the EuroQol 5-dimension 5 L questionnaire as an anchor. RESULTS: < .001), confirming the concurrent validity. Although the construct validity of UWS was somewhat low, it was judged to be comparable to that of 6MWD, which was used as an indicator of postoperative recovery. The ES and SRM of UWS were 0.56 and 0.73, respectively. The MCID of UWS was determined to be -0.18 m/s (area under the curve: 0.751 [95% confidence interval: 0.612 - 0.889]). CONCLUSION: Regarding indicators of postoperative recovery, UWS, with low patient burden, short measurement time, and no need for a large space, may be a useful surrogate in settings and cases where 6MWD could not be evaluated, with an MCID of -0.18 m/s from before surgery to 1 week after in patients with CRC.

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