The minimal important difference for the Postural Assessment Scale for Stroke Patients in the subacute stage

Hung-Pin Lien; Yun-Jer Shieh; Chih-Ping Chen; Yi-Jing Huang; Inga Wang; Mei-Hsiang Chen; Ching-Lin Hsieh

doi:10.1016/j.bjpt.2024.100595

The minimal important difference for the Postural Assessment Scale for Stroke Patients in the subacute stage

Braz J Phys Ther. 2024 Jan-Feb;28(1):100595. doi: 10.1016/j.bjpt.2024.100595. Epub 2024 Feb 19.

Authors

Hung-Pin Lien¹, Yun-Jer Shieh², Chih-Ping Chen³, Yi-Jing Huang⁴, Inga Wang⁵, Mei-Hsiang Chen⁶, Ching-Lin Hsieh⁷

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan.
² School of Occupational Therapy, College of Medicine, National Taiwan University, 4F, No. 17, Xuzhou Road, Taipei, Taiwan.
³ Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung, Taiwan.
⁴ School of Occupational Therapy, College of Medicine, National Taiwan University, 4F, No. 17, Xuzhou Road, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: yijinghuang@ntu.edu.tw.
⁵ Department of Rehabilitation Sciences & Technology, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
⁶ Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan; Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁷ School of Occupational Therapy, College of Medicine, National Taiwan University, 4F, No. 17, Xuzhou Road, Taipei, Taiwan; Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.

Abstract

Background: The minimal important difference (MID) of the Postural Assessment Scale for Stroke Patients (PASS) remains unknown, limiting the interpretation of change scores.

Objectives: To estimate the MID of the PASS in patients with subacute stroke.

Methods: Data at admission and discharge for 240 participants were retrieved from a longitudinal study. The "mobility" item of the Barthel Index was used as the anchor for indicating the improvement of posture control. Receiver operating characteristic (ROC) method was used to estimate the anchor-based MID of the PASS.

Results: The ROC method identified a MID of 3.0 points, with a sensitivity of 81.0 % and a specificity of 75.6 %.

Conclusion: The MID of the PASS was 3.0 points, indicating that if a patient achieves an improvement of 3.0 or more points on the PASS, they have a clinically important improvement in posture control. Our results can help in interpreting change scores and aid in understanding the clinical values of treatment outcomes.

Keywords: Anchor-based; Minimum clinically important difference; Outcome assessment; Posture control; Stroke.

MeSH terms

Hospitalization
Humans
Longitudinal Studies
Stroke Rehabilitation*
Stroke*
Treatment Outcome