Reliability and minimal clinically important differences of gait characteristics in peripheral vestibular disorders.

OBJECTIVE

Sensory gait ataxia is a core feature of chronic peripheral vestibular disorders, leading to impaired mobility, reduced quality of life, and increased fall risk. Quantitative gait metrics capturing this deficit are valuable endpoints for clinical trials, yet data on their reliability and clinically meaningful change remain limited.

METHODS

Gait was recorded in 60 patients with chronic bilateral (n = 30) or unilateral (n = 30) vestibular failure on an instrumented walkway during self-selected, slow, and eyes-closed walking. Test-retest reliability was quantified using intraclass correlation coefficients across five gait domains: pace, phase, variability, asymmetry, and postural control. Minimal clinically important differences (MCIDs) were estimated using distribution- and anchor-based methods. Anchors included established measures of mobility, fall-related self-efficacy, and quality of life: the Functional Gait Assessment, Falls Efficacy Scale-International, and the Physical Component Score of the Short Form Health Survey.

RESULTS

Self-selected walking showed good-to-excellent reliability across all domains except asymmetry, with similar results for slow and eyes-closed walking. Clinically meaningful changes were linked to faster gait, longer swing phases, lower variability and asymmetry, and narrower stride width, enabling MCID determination for each metric.

CONCLUSION

Quantitative gait metrics can be reliably assessed in peripheral vestibular disorders and provide robust, clinically relevant endpoints for future intervention studies.