PMID- 18760153
OWN - NLM
STAT- MEDLINE
DCOM- 20080923
LR  - 20220409
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Print)
IS  - 0003-9993 (Linking)
VI  - 89
IP  - 9
DP  - 2008 Sep
TI  - Estimating minimal clinically important differences of upper-extremity measures 
      early after stroke.
PG  - 1693-700
LID - 10.1016/j.apmr.2008.02.022 [doi]
AB  - OBJECTIVE: To estimate minimal clinically important difference (MCID) values of 
      several upper-extremity measures early after stroke. DESIGN: Data in this report 
      were collected during the Very Early Constraint-induced Therapy for Recovery of 
      Stroke trial, an acute, single-blind randomized controlled trial of 
      constraint-induced movement therapy. Subjects were tested at the prerandomization 
      baseline assessment (average days poststroke, 9.5d) and the first posttreatment 
      assessment (average days poststroke, 25.9d). At each time point, the affected 
      upper extremity was evaluated with a battery of 6 tests. At the second 
      assessment, subjects were also asked to provide a global rating of perceived 
      changes in their affected upper extremity. Anchor-based MCID values were 
      calculated separately for the affected dominant upper extremities and the 
      affected nondominant upper extremities for each of the 6 tests. SETTING: 
      Inpatient rehabilitation hospital. PARTICIPANTS: Fifty-two people with 
      hemiparesis poststroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: 
      Estimated MCID values for grip strength, composite upper-extremity strength, 
      Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Motor Activity 
      Log (MAL), and duration of upper-extremity use as measured with accelerometry. 
      RESULTS: MCID values for grip strength were 5.0 and 6.2 kg for the affected 
      dominant and nondominant sides, respectively. MCID values for the ARAT were 12 
      and 17 points, for the WMFT function score were 1.0 and 1.2 points, and for the 
      MAL quality of movement score were 1.0 and 1.1 points for the 2 sides, 
      respectively. MCID values were indeterminate for the dominant (composite 
      strength), the nondominant (WMFT time score), and both affected sides (duration 
      of use) for the other measures. CONCLUSIONS: Our data provide some of the first 
      estimates of MCID values for upper-extremity standardized measures early after 
      stroke. Future studies with larger sample sizes are needed to refine these 
      estimates and to determine whether MCID values are modified by time poststroke.
FAU - Lang, Catherine E
AU  - Lang CE
AD  - Program in Physical Therapy, Washington University School of Medicine, St. Louis, 
      MO 63108, USA. langc@wustl.edu
FAU - Edwards, Dorothy F
AU  - Edwards DF
FAU - Birkenmeier, Rebecca L
AU  - Birkenmeier RL
FAU - Dromerick, Alexander W
AU  - Dromerick AW
LA  - eng
GR  - K01 HD047669-03/HD/NICHD NIH HHS/United States
GR  - K01 HD047669-04/HD/NICHD NIH HHS/United States
GR  - HD047669/HD/NICHD NIH HHS/United States
GR  - R01 NS041261-01A1/NS/NINDS NIH HHS/United States
GR  - NS41261/NS/NINDS NIH HHS/United States
GR  - R01 NS041261-02/NS/NINDS NIH HHS/United States
GR  - R01 NS041261-03/NS/NINDS NIH HHS/United States
GR  - K01 HD047669/HD/NICHD NIH HHS/United States
GR  - R01 NS041261/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
SB  - IM
MH  - Disability Evaluation
MH  - Female
MH  - Hand Strength
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Paresis/*physiopathology/*rehabilitation
MH  - Single-Blind Method
MH  - Statistics, Nonparametric
MH  - Stroke/*physiopathology
MH  - *Stroke Rehabilitation
MH  - Treatment Outcome
MH  - Upper Extremity/*physiopathology
PMC - PMC2819021
MID - NIHMS168872
COIS- We certify that no party having a direct interest in the results of the research 
      supporting this article has or will confer a benefit on us or on any organization 
      with which we are associated AND, if applicable, we certify that all financial 
      and material support for this research (eg, NIH or NHS grants) and work are 
      clearly identified in the title page of the manuscript.
EDAT- 2008/09/02 09:00
MHDA- 2008/09/24 09:00
PMCR- 2010/02/10
CRDT- 2008/09/02 09:00
PHST- 2007/11/12 00:00 [received]
PHST- 2008/01/11 00:00 [revised]
PHST- 2008/02/06 00:00 [accepted]
PHST- 2008/09/02 09:00 [pubmed]
PHST- 2008/09/24 09:00 [medline]
PHST- 2008/09/02 09:00 [entrez]
PHST- 2010/02/10 00:00 [pmc-release]
AID - S0003-9993(08)00405-X [pii]
AID - 10.1016/j.apmr.2008.02.022 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2008 Sep;89(9):1693-700. doi: 10.1016/j.apmr.2008.02.022.