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Published on: March 28, 2018
Estimating minimal clinically important differences of upper-extremity measures early after stroke
Catherine E Lang1, Dorothy F Edwards, Rebecca L Birkenmeier
1Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA. langc@wustl.edu
Archives of Physical Medicine and Rehabilitation
|September 2, 2008
Summary
This study provides early estimates for minimal clinically important difference (MCID) in upper-extremity function after stroke. These findings aid in interpreting changes in recovery using standardized measures.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Clinical Measurement
Background:
- Stroke frequently causes upper-extremity hemiparesis, impacting daily function.
- Quantifying meaningful recovery is crucial for guiding rehabilitation and interpreting clinical trial outcomes.
- Minimal Clinically Important Difference (MCID) provides a threshold for treatment effect that patients perceive as beneficial.
Purpose of the Study:
- To estimate MCID values for various upper-extremity measures in the early phase post-stroke.
- To establish benchmarks for clinically meaningful improvement in stroke recovery.
Main Methods:
- Utilized data from the Very Early Constraint-induced Therapy for Recovery of Stroke (VECTORS) trial.
- Assessed 52 participants with hemiparesis at baseline and post-treatment (average 9.5 and 25.9 days poststroke).
- Employed anchor-based methods using patient-reported global rating of change to determine MCID for grip strength, ARAT, WMFT, and MAL.
Main Results:
- Estimated MCID values for grip strength (5.0-6.2 kg), Action Research Arm Test (12-17 points), WMFT function score (1.0-1.2 points), and MAL quality of movement score (1.0-1.1 points).
- MCID values were indeterminate for composite strength, WMFT time score, and duration of upper-extremity use in certain limb conditions.
Conclusions:
- This study offers initial MCID estimates for key upper-extremity measures in early stroke recovery.
- Further research with larger cohorts is necessary to refine these estimates and explore the influence of time poststroke.
