Minimal clinically important difference of the lower-extremity fugl-meyer assessment in chronic-stroke

Top Stroke Rehabil. 2016 Aug;23(4):233-9. doi: 10.1179/1945511915Y.0000000003. Epub 2016 Apr 16.

Abstract

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.

Keywords: Fugl–Meyer assessment; Lower extremity; Minimal clinically important difference; Motor recovery; Stroke rehabilitation.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Female
  • Humans
  • Lower Extremity / physiopathology*
  • Male
  • Middle Aged
  • Minimal Clinically Important Difference*
  • Paresis / etiology
  • Paresis / therapy*
  • Prospective Studies
  • Severity of Illness Index*
  • Stroke / complications
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*