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Application of a Dual Upper Limb Task-Oriented Robotic System for the Functional Recovery of the Upper Limb in Stroke Patients
Published on: October 11, 2024
Estimating the minimal clinically important difference of an upper extremity recovery measure in subacute stroke
Kamal Narayan Arya1, Rajesh Verma, R K Garg
1Department of Neurology, CSM Medical University, Lucknow, India.
Background:
The minimal clinically important difference (MCID) estimates of some of the stroke-related measures are available; but MCID of the Fugl-Meyer assessment (FMA) measure is unknown, which limits the application and interpretation of change scores in poststroke patients with motor deficits.
Objective:
To estimate the MCID of the FMA-UE (upper extremity) using the modified Rankin scale (mRS) and global rating of patient-perceived changes (GRPPC) in subacute poststroke patients.
Methods:
The prospective, cohort study took place in the neurology department of a university hospital. Seventy-one subacute poststroke (mean duration, 8.42 weeks) patients were prospectively enrolled in a randomized clinical trial of the ongoing Meaningful Task Specific Training (MTST). FMA-UE, mRS, and GRPPC scores were obtained at pre- and 4 weeks postintervention.
Results:
The MCID values of FMA-UE were 9 (80.39% sensitive and 70% specific) and 10 (97.62% sensitive and 89.66% specific) anchored to mRS and GRPPC, respectively.
Conclusions:
The estimated MCID score for the upper extremity motor recovery among patients with subacute stroke is 9 to 10 on the FMA-UE. Patients with subacute stroke who achieve a score of 9 to 10 on FMA-UE are more likely to experience or perceive a meaningful and clinically important improvement in their disability level than those who do not. The reference value can be used to develop goals and interpret progress in subacute poststroke patients.
