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Responsiveness and Minimal Clinically Important Difference of Balance Assessment Tools in Parkinson's Disease
Zeynep Candan1, Mehmet A Güler2, Mürvet Arda Koroglu3
1Sancaktepe Sehit Prof. Dr. İlhan Varank Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey.
Background:
Responsiveness and minimal clinically important difference (MCID) are among the psychometric properties necessary for interpreting results. However, responsiveness and MCID of the Falls Efficacy Scale-International (FES-I) and the Biodex Balance System (Biodex-BS) in individuals with Parkinson's disease (PD) have not yet been determined.
Objectives:
The objective of this study is to establish the responsiveness and MCID of FES-I and Biodex-BS, as well as Berg Balance Scale, Time up and Go (TUG) test, Tinetti Gait and Balance Scale (TGBS), and Mini-Balance Evaluation Systems Test in PD.
Methods:
In this prospective observational cohort study, 86 individuals with PD were assessed. Responsiveness was evaluated utilizing 11 predefined hypotheses. MCID was calculated using anchor and distribution-based methods. In this study, the Global Rating of Change-Patient (GRC-P) and Global Rating of Change-Therapist (GRC-T) and the Activity-Specific Balance Confidence Scale (ABC) were used as anchors. ROC analysis was utilized in the anchor-based method.
Results:
The Fall Risk Test-Overall Stability Index (FRT-OSI), one of the Biodex-BS parameters, showed the highest responsiveness. TUG and FES-I indicated a substantial responsiveness, while the TGBS demonstrated the lowest responsiveness. MCID of FRT-OSI, which had the highest responsiveness, had 0.78 with the distribution-based method. In the anchor-based method, MCID with GRC-P, GRC-T, and ABC anchors were 0.54, 0.95, and 0.54, respectively.
Conclusions:
FRT-OSI demonstrated the highest responsiveness in PD. TUG and FES-I may be used as alternatives when a Biodex-BS is inaccessible. TGBS clinical utility may be limited. MCIDs determined in this study may help interpret the clinical importance of the results.
