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Estimating Minimal Clinically Important Differences for Knee Range of Motion after Stroke.

Agnieszka Guzik1, Mariusz Drużbicki1, Andżelina Wolan-Nieroda1

  • 1Department of Physiotherapy, Institute of Health Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland.

Journal of Clinical Medicine
|October 20, 2020
PubMed
Summary

Researchers determined the minimal clinically important differences (MCID) for knee range of motion in stroke survivors. This helps understand meaningful improvements in walking performance after stroke.

Keywords:
gaithemiplegiaminimal clinically important differencestroke

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Area of Science:

  • Rehabilitation Medicine
  • Biomechanics
  • Neuroscience

Background:

  • Knee sagittal kinematic parameters are crucial for predicting post-stroke walking performance.
  • Minimal clinically important differences (MCID) are essential for evaluating the clinical relevance of gait parameter changes in stroke patients.
  • No prior studies have established MCID for knee range of motion (ROM) in chronic stroke survivors.

Purpose of the Study:

  • To estimate the MCID for knee ROM in the sagittal plane for both affected and unaffected legs in individuals with chronic stroke.
  • To provide clinicians and researchers with benchmarks for interpreting changes in knee kinematic parameters.

Main Methods:

  • The study analyzed data from 50 individuals with chronic stroke.
  • MCID values were estimated using four methods: anchor-based, distribution-based, linear regression with the Barthel Index, and Receiver Operating Characteristic (ROC) curve analysis.
  • Knee flexion/extension ROM in the sagittal plane was measured.

Main Results:

  • Anchor-based method yielded MCID estimates of 8.48° for the affected side and 6.81° for the unaffected side.
  • Distribution-based method provided an MCID estimate of 1.86°/5.63° (standard error of measurement).
  • ROC curve analysis identified 3.9°/3.8° as the optimal cut-off for MCID in knee sagittal ROM.

Conclusions:

  • The study determined MCID estimates for knee sagittal ROM in chronic stroke: 8.48° for the affected side and 6.81° for the unaffected side.
  • These findings offer valuable guidance for clinicians and researchers in assessing the clinical significance of changes in knee kinematics post-stroke.
  • The results contribute to a better understanding of gait recovery and rehabilitation effectiveness in stroke survivors.