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Updated: Jan 24, 2026

Author Spotlight: Using Motor Imagery Brain-Computer Interface to Improve Motor and Cognitive Function in Stroke Patients
Published on: September 1, 2023
Responsiveness, Minimal Clinically Important Difference, and Validity of the MoCA in Stroke Rehabilitation
Ching-Yi Wu1,2, Shuan-Ju Hung3, Keh-Chung Lin3,4
1Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Objective:
Persons with stroke frequently suffer from cognitive impairment. The Montreal Cognitive Assessment (MoCA), a recently developed screening tool, is sensitive to poststroke cognitive deficits. The present study assessed its psychometric and clinimetric properties (i.e., responsiveness, minimal clinically important difference (MCID), and criterion validity) in stroke survivors receiving rehabilitative therapy.
Method:
The MoCA and the Stroke Impact Scale (SIS) were administered to 65 stroke survivors before and after 4 to 5 weeks of therapy. The effect size and standardized response mean (SRM) were calculated for responsiveness. Anchor- and distribution-based methods were used to estimate the MCID. Criterion validity was measured with the Spearman correlation coefficient.
Results:
The responsiveness of the MoCA was moderate (SRM = 0.67). Participants exceeding the MCID according to the anchor- and distribution-based approaches were 33 (50.77%) and 20 (30.77%), respectively. Fair to good concurrent validity was reported between the MoCA and the SIS communication subscale. The MoCA had satisfactory predictive validity with the SIS communication and memory subscales.
Conclusion:
This study may support the responsiveness, MCID, and criterion validity of the MoCA in stroke populations. Future studies with larger sample sizes are needed to validate the current findings.
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