PMID- 31359626
OWN - NLM
STAT- MEDLINE
DCOM- 20210720
LR  - 20210720
IS  - 1934-1563 (Electronic)
IS  - 1934-1482 (Linking)
VI  - 12
IP  - 3
DP  - 2020 Mar
TI  - Minimal Clinically Important Difference of Four Commonly Used Balance Assessment 
      Tools in Individuals after Total Knee Arthroplasty: A Prospective Cohort Study.
PG  - 238-245
LID - 10.1002/pmrj.12226 [doi]
AB  - BACKGROUND: Although balance is commonly assessed during the recovery of total 
      knee arthroplasty (TKA), the minimal clinically important difference (MCID) 
      values of frequently used balance assessment tools have not been established 
      previously in this population. OBJECTIVE: To determine the MCID of four balance 
      tests-ie, the Balance Evaluation Systems Test (BESTest), Mini-BESTest, 
      Brief-BESTest, and the Berg Balance Scale (BBS)-in individuals post-TKA. DESIGN: 
      Prospective cohort. SETTING: Outpatient rehabilitation. PARTICIPANTS: Inclusion 
      criteria: (1) first primary TKA with diagnosed knee osteoarthritis; (2) aged 
      50-85 years. EXCLUSION CRITERIA: (1) TKA due to rheumatoid arthritis of the knee 
      or traumatic injury; (2) known medical conditions that influence balance ability. 
      One hundred forty-six participants were recruited, and 134 of them with complete 
      data were included in the analysis. INTERVENTIONS: Participants received 
      individualized physiotherapy, consisting of electrotherapy for pain and edema 
      control, mobilization and strengthening exercises, and gait and balance training, 
      once or twice per week between assessments. MAIN OUTCOME MEASUREMENTS: 
      Participants were assessed on the BESTest, Mini-BESTest, Brief-BESTest, BBS, and 
      Functional Gait Assessment (FGA) 2 and 4 weeks after surgery. The FGA was used as 
      the anchor reference measure to calculate the MCID of the other four balance 
      tests. A distribution-based approach was also employed to derive the MCID (ie, 
      standardized effect size of 0.5). RESULTS: The BESTest (area under curve 
      [AUC] = 0.811, 95% confidence interval [CI] 0.739-0.883) had the highest accuracy 
      in detecting clinically important improvements on the FGA (>/=4 points), followed 
      by the Mini-BESTest (AUC = 0.782, 95% CI 0.704-0.860), Brief-BESTest 
      (AUC = 0.701, 95% CI 0.618-0.795), and BBS (AUC = 0.586, 95% CI 0.490-0.682). The 
      anchor- and distribution-based MCIDs were 6-8 for the BESTest, 1-2 for the 
      Mini-BESTest, and 2-3 for the Brief-BESTest. CONCLUSIONS: Improvements exceeding 
      MCIDs established above are indicative of significant progress in balance 
      function post-TKA. The BBS is not a recommended tool due to its low AUC value.
CI  - (c) 2019 American Academy of Physical Medicine and Rehabilitation.
FAU - Chan, Andy C M
AU  - Chan ACM
AD  - Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong 
      Kong, China.
AD  - Physiotherapy Department, Queen Elizabeth Hospital, Hong Kong, China.
FAU - Pang, Marco Y C
AU  - Pang MYC
AD  - Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong 
      Kong, China.
FAU - Ouyang, Huixi
AU  - Ouyang H
AUID- ORCID: 0000-0002-0941-8484
AD  - Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong 
      Kong, China.
AD  - Physiotherapy Department, Guangdong Provincial Work Injury Rehabilitation 
      Hospital, Guangzhou, China.
FAU - Jehu, Deborah A M
AU  - Jehu DAM
AD  - Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong 
      Kong, China.
AD  - Department of Physical Therapy, Faculty of Medicine, University of British 
      Columbia, Vancouver, British Columbia, Canada.
AD  - Center for Hip Health & Mobility, Vancouver Coastal Health Research Institute, 
      University of British Columbia, Vancouver, British Columbia, Canada.
LA  - eng
PT  - Journal Article
DEP - 20191001
PL  - United States
TA  - PM R
JT  - PM & R : the journal of injury, function, and rehabilitation
JID - 101491319
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Arthroplasty, Replacement, Knee/rehabilitation
MH  - Disability Evaluation
MH  - Humans
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Physical Therapy Modalities
MH  - *Postural Balance
MH  - Prospective Studies
MH  - Reproducibility of Results
EDAT- 2019/07/31 06:00
MHDA- 2021/07/21 06:00
CRDT- 2019/07/31 06:00
PHST- 2019/01/23 00:00 [received]
PHST- 2019/07/22 00:00 [accepted]
PHST- 2019/07/31 06:00 [pubmed]
PHST- 2021/07/21 06:00 [medline]
PHST- 2019/07/31 06:00 [entrez]
AID - 10.1002/pmrj.12226 [doi]
PST - ppublish
SO  - PM R. 2020 Mar;12(3):238-245. doi: 10.1002/pmrj.12226. Epub 2019 Oct 1.