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Updated: Mar 22, 2026
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
Minimal clinically important difference of the lower-extremity fugl-meyer assessment in chronic-stroke
Shanta Pandian1, Kamal Narayan Arya1, Dharmendra Kumar1
1a Pandit Deendayal Upadhyaya Institute for the Physically Handicapped , New Delhi , India.
Background:
The Minimal Clinically Important Difference (MCID), the smallest difference in the treatment outcome, augments both clinical and research practice. The MCID of the Fugl-Meyer assessment: Lower extremity (FMA-LE), an important motor measure in stroke, is not known.
Objective:
To estimate MCID score of FMA-LE using an anchor-based approach in chronic poststroke hemiparetic (>6 months) stroke subjects.
Design:
A prospective, observational study.
Setting:
Occupational therapy department of a rehabilitation institute.
Participants:
Sixty-five poststroke hemiparetic subjects (Mean age = 44.22 years, 42 men, Mean poststroke duration = 16.42 months).
Intervention:
The conventional motor therapy based on neurophysiological approaches was provided for the affected lower extremity (30 sessions, 45 min each, 3/week).
Outcome Measures:
FMA-LE, Functional ambulation classification (FAC), and global rating of patient-perceived changes (GRPPC).
Result:
The estimated MCID of FMA-LE was found to be a score of 6 using both FAC (sensitivity 90, specificity 94) and GRPPC (sensitivity 87, specificity 91).
Conclusion:
In chronic poststroke hemiparetic subjects, the computed MCID of FMA-LE is a score of 6. The subjects who achieve a change in a score of 6 on FMA-LE would perceive a meaningful recovery of lower-extremity function than those who do not. The reference value may be utilized in stroke rehabilitation.
Insights
The Minimal Clinically Important Difference (MCID) for the Fugl-Meyer assessment: Lower extremity (FMA-LE) in chronic stroke patients is 6. This score indicates a meaningful recovery in lower-extremity function, aiding clinical practice and research.
Area of Science:
- Rehabilitation Medicine
- Neuroscience
- Clinical Motor Assessment
Background:
- The Minimal Clinically Important Difference (MCID) is crucial for interpreting treatment outcomes in clinical and research settings.
- The MCID for the Fugl-Meyer assessment: Lower extremity (FMA-LE), a key motor function measure post-stroke, was previously undetermined.
Purpose of the Study:
- To establish the MCID for the FMA-LE in individuals with chronic hemiparetic stroke using an anchor-based methodology.
Main Methods:
- A prospective, observational study was conducted involving 65 chronic post-stroke hemiparetic participants (mean duration >16 months).
- Participants received conventional motor therapy focused on neurophysiological approaches for the affected lower extremity.
- The FMA-LE was assessed alongside the Functional Ambulation Classification (FAC) and a global rating of patient-perceived changes (GRPPC) to determine MCID.
Main Results:
- An MCID score of 6 for the FMA-LE was estimated using both the FAC (sensitivity 90%, specificity 94%) and GRPPC (sensitivity 87%, specificity 91%).
Conclusions:
- A score of 6 on the FMA-LE represents the MCID for chronic post-stroke hemiparetic subjects, signifying a meaningful improvement in lower-extremity function.
- This established reference value can enhance the interpretation of FMA-LE scores in stroke rehabilitation research and clinical practice.
