Minimal Detectable Change and Clinically Important Difference of the Wolf Motor Function Test in Stroke Patients

Lin, Keh‐chung; Hsieh, Yu‐Wei; Wu, Ching‐yi; Chen, Chia‐Ling; Jang, Yuh; Liu, Jung‐Sen

doi:10.1177/1545968308331144

Cited by 166 publications

(129 citation statements)

References 42 publications

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“…27 One SEM has been described as the preferred method for establishing the minimal detectable change (MDC) to identify important change beyond measurement error. 16,39 The SEM quantifies the measurement error in the units of the original measurement, which provides a clinically meaningful value to be interpreted by the clinician. 32 Ninety-five percent confidence intervals (CIs) were calculated for all reliability coefficients.…”

Section: Discussionmentioning

confidence: 99%

“…6 The within-patients change score was calculated as the mean change score (posttreatment minus baseline score) for each of the 4 physical performance measures, that corresponded to patients who were defined as having shown major improvement (that is, those with a GRCS greater than +5). 10,16 Using this approach, the MCII represents the mean change in scores of the major-improvement patients. The between-patients change score was calculated as the difference in the change score of the major-improvement and unimportant-change patients.…”

Section: Discussionmentioning

confidence: 99%

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A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Wright¹,

Cook²,

Baxter³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

322

246

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For rehabilitation professionals engaged in the treatment of osteoarthritis (OA), it is standard practice to perform objective assessments of physical function (using both physical performance and self-report measures) to obtain a picture of patient status. These assessments also serve as a baseline value for estimating changes (treatment effects) over time. While reliability and validity of some commonly used physical performance measures have been investigated in an OA population, most require further research regarding clinical utility and responsiveness. 14 Physical performance measures have often been criticized, as detailed testing of their measurement properties has not been extensively reported. 14,22,33 Measures of responsiveness have commonly been reported as statistically significant change scores, which are useful in establishing the threshold of change needed beyond measurement error. 10 Investigation of minimal clinically important differences (MCIDs) of physical performance measures is warranted, as these have become commonly used outcome measures in the treatment of OA. 8,12,17,[35][36][37] At present, the responsiveness (in terms of MCID) of the timed up-and-go (TUG) test, 40-meter self-paced walk test (40-m SPWT), 30-second chair stand (30 CST), and 20-cm step test has not been investigated in T T STUDY DESIGN: Prospective cohort study. T T OBJECTIVES:To establish the major clinically important improvement (MCII) of the timed upand-go test (TUG), 40-meter self-paced walk test (40-m SPWT), 30-second chair stand (30 CST), and a 20-cm step test in patients with hip osteoarthritis (OA) undergoing physiotherapy treatment. As a secondary aim, a comparison of methods was employed to evaluate the effect of method on the reported MCII. T T BACKGROUND: Minimal clinically importantdifference scores are commonly used by rehabilitation professionals to determine patient response following treatment. A gold standard for calculating MCII has yet to be determined, which has resulted in problems of interpretation due to varied results. T T METHODS:As part of a randomized controlled trial, 65 patients were randomized into a physiotherapy treatment group for hip OA, in which they completed 4 physical performance measures at baseline and 9 weeks. Upon completion of physiotherapy, patients assessed their response to treatment on a 15-point global rating of change scale (GRCS). MCII was estimated using 3 variations of an anchor-based method, based on the patient's opinion. T T RESULTS:A comparison of 3 methods resulted in the following change scores being best associated with our definition of MCII: a reduction equal to or greater than 0.8, 1.4, and 1.2 seconds for the TUG; an increase equal to or greater than 0.2, 0.3, and 0.2 m/s for the 40-m SPWT; an increase equal to or greater than 2.0, 2.6, and 2.1 repetitions for the 30 CST; an increase equal to or greater than 5.0, 12.8, and 16.4 steps for the 20-cm step test. T T CONCLUSION:The variation in methods provided very different results. This illustrates the impor...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Wright¹,

Cook²,

Baxter³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

322

246

View full text Add to dashboard Cite

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“…The participant demonstrated improvement on all motor outcomes and all but one nonmotor outcome at EOT and maintained or improved at EOT14 (Tables 2 and 3). Tables 2 and 3 also display minimal clinically important difference (MCID) and minimal detectable change (MDC; Fulk et al, 2008;Lang, Edwards, Birkenmeier, & Dromerick, 2008;Lin et al, 2009;Page, Fulk, & Boyne, 2012). The participant demonstrated a 20-point improvement on the FMA at EOT, achieving the MCID and MDC at EOT and EOT14.…”

Section: Resultsmentioning

confidence: 99%

Forced Aerobic Exercise Enhances Motor Recovery After Stroke: A Case Report

Linder

Rosenfeldt

Rasanow

et al. 2015

The American Journal of Occupational Therapy

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OBJECTIVE. Previously, we demonstrated that forced aerobic exercise (FE) increases the pattern of neural activation in Parkinson's disease. We sought to evaluate whether FE, when coupled with repetitive task practice, could promote motor recovery poststroke. METHOD.A 46-yr-old man with ischemic stroke exhibited chronic residual upper-extremity deficits, scoring 35/66 on the Fugl-Meyer Assessment (FMA) at baseline. He completed 24 training sessions comprising 45 min of FE on a motorized stationary bicycle followed by 45 min of upper-extremity repetitive task practice. RESULTS.From baseline to end of treatment, the FMA score improved by 20 points, perceived level of recovery on the Stroke Impact Scale increased by 20 percentage points, and cardiovascular function measured by peak oxygen uptake improved 30%. These improvements persisted 4 wk after the intervention ceased.

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“…In the past 5 years, a number of UL function tests have been examined for their psychometric and clinimetric properties in people with stroke, including the FuglMeyer Assessment (FMA) [6][7][8], Wolf Motor Function Test (WMFT) [6,[9][10][11], Box and Block Test (BBT) [7,[12][13][14], Nine-Hole Peg Test (NHPT) [12,[15][16][17], Action Research Arm Test (ARAT) [6][7][8]11,[16][17][18], and Stroke Impact Scale (SIS) [16,[19][20]. The comparisons of outcome measures of UL motor function have been investigated in patients with stroke [6][7]16,21].…”

Section: Introductionmentioning

confidence: 99%

Responsiveness and validity of three dexterous function measures in stroke rehabilitation

Lin

Chuang²,

et al. 2010

JRRD

Self Cite

135

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Abstract-In this study, we compared the responsiveness and validity of the Box and Block Test (BBT), the Nine-Hole Peg Test (NHPT), and the Action Research Arm Test (ARAT). We randomized 59 patients with stroke into one of three rehabilitation treatments for 3 weeks. We administered six outcome measures (BBT, NHPT, ARAT, Fugl-Meyer Assessment [FMA], Motor Activity Log [MAL], and Stroke Impact Scale [SIS] hand function domain) pretreatment and posttreatment. We used the standardized response mean (SRM) to examine responsiveness and the Spearman rank correlation coefficient (rho) to examine concurrent validity. The BBT, NHPT, and ARAT were moderately responsive to change and not significantly different (SRM = 0.64-0.79). The correlations within the BBT, NHPT, and ARAT were moderate to good at pretreatment (rho = -0.55 to -0.80) and posttreatment (rho = -0.57 to -0.71). The BBT and ARAT showed fair to moderate correlations with the FMA, MAL, and SIS hand function domain at pretreatment and posttreatment (rho = 0.31-0.59), whereas the NHPT demonstrated low to fair correlations with the FMA and MAL (rho = -0.16 to -0.33) and moderate correlations with the SIS hand function domain (rho = -0.58 to -0.66). Our results indicate that the BBT, NHPT, and ARAT are suitable to detect changes over time. While simultaneously considering the responsiveness and validity attributes, the BBT and ARAT can be considered more appropriate for evaluating dexterous function than the NHPT. Further studies with larger samples are needed to validate these findings. Clinical

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Minimal Detectable Change and Clinically Important Difference of the Wolf Motor Function Test in Stroke Patients

Cited by 166 publications

References 42 publications

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

A Comparison of 3 Methodological Approaches to Defining Major Clinically Important Improvement of 4 Performance Measures in Patients With Hip Osteoarthritis

Forced Aerobic Exercise Enhances Motor Recovery After Stroke: A Case Report

Responsiveness and validity of three dexterous function measures in stroke rehabilitation

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