PMID- 32509855 OWN - NLM STAT- MEDLINE DCOM- 20210325 LR - 20220414 IS - 2314-6141 (Electronic) IS - 2314-6133 (Print) VI - 2020 DP - 2020 TI - Minimum Clinically Important Difference of Gross Motor Function and Gait Endurance in Children with Motor Impairment: A Comparison of Distribution-Based Approaches. PG - 2794036 LID - 10.1155/2020/2794036 [doi] LID - 2794036 AB - OBJECTIVE: The minimum clinically important difference (MCID) is a standard way of measuring clinical relevance. The objective of this work was to establish the MCID for the 6-minute walking test (6minWT) and the Gross Motor Function Measure (GMFM-88) in pediatric gait disorders. METHODS: A cohort, pretest-posttest study was conducted in a hospitalized care setting. A total of 182 patients with acquired brain injury (ABI) or cerebral palsy (CP) performed 20 robot-assisted gait training sessions complemented with 20 sessions of physical therapy over 4 weeks. Separate MCIDs were calculated using 5 distribution-based approaches, complemented with an anonymized survey completed by clinical professionals. RESULTS: The MCID range for the 6minWT was 20-38 m in the ABI cohort, with subgroup ranges of 20-36 m for GMFCS I-II, 23-46 m for GMFCS III, and 24-46 m for GMFCS IV. MCIDs for the CP population were 6-23 m, with subgroup ranges of 4-28 m for GMFCS I-II, 9-19 m for GMFCS III, and 10-27 m for GMFCS IV. For GMFM-88 total score, MCID values were 1.1%-5.3% for the ABI cohort and 0.1%-3.0% for the CP population. For dimension "D" of the GMFM, MCID ranges were 2.3%-6.5% and 0.8%-5.2% for ABI and CP populations, respectively. For dimension "E," MCID ranges were 2.8%-6.5% and 0.3%-4.9% for ABI and CP cohorts, respectively. The survey showed a large interquartile range, but the results well mimicked the distribution-based methods. CONCLUSIONS: This study identified for the first time MCID ranges for 6minWT and GMFM-88 in pediatric patients with neurological impairments, offering useful insights for clinicians to evaluate the impact of treatments. Distribution-based methods should be used with caution: methods based on pre-post correlation may underestimate MCID when applied to patients with small improvements over the treatment period. Our results should be complemented with estimates obtained using consensus- and anchor-based approaches. CI - Copyright (c) 2020 Fabio Alexander Storm et al. FAU - Storm, Fabio Alexander AU - Storm FA AUID- ORCID: 0000-0002-5977-8090 AD - Scientific Institute, IRCCS "E. Medea", Bioengineering Laboratory, Bosisio Parini, Lecco, Italy. FAU - Petrarca, Maurizio AU - Petrarca M AUID- ORCID: 0000-0002-7330-3569 AD - Bambino Gesu Children's Hospital, Neurosciences and Neurorehabilitation, Rome, Italy. FAU - Beretta, Elena AU - Beretta E AUID- ORCID: 0000-0002-8036-7624 AD - Scientific Institute, IRCCS "E. Medea", Acquired Brain Injury Unit, Bosisio Parini, Lecco, Italy. FAU - Strazzer, Sandra AU - Strazzer S AUID- ORCID: 0000-0001-8414-6565 AD - Scientific Institute, IRCCS "E. Medea", Acquired Brain Injury Unit, Bosisio Parini, Lecco, Italy. FAU - Piccinini, Luigi AU - Piccinini L AD - Scientific Institute, IRCCS "E. Medea", Functional Rehabilitation Unit, Bosisio Parini, Lecco, Italy. FAU - Maghini, Cristina AU - Maghini C AUID- ORCID: 0000-0003-1668-7954 AD - Scientific Institute, IRCCS "E. Medea", Functional Rehabilitation Unit, Bosisio Parini, Lecco, Italy. FAU - Panzeri, Daniele AU - Panzeri D AUID- ORCID: 0000-0002-3511-8709 AD - Scientific Institute, IRCCS "E. Medea", Bioengineering Laboratory, Bosisio Parini, Lecco, Italy. FAU - Corbetta, Claudio AU - Corbetta C AD - Scientific Institute, IRCCS "E. Medea", Bioengineering Laboratory, Bosisio Parini, Lecco, Italy. FAU - Morganti, Roberta AU - Morganti R AUID- ORCID: 0000-0002-3895-7372 AD - Scientific Institute, IRCCS "E. Medea", Acquired Brain Injury Unit, Bosisio Parini, Lecco, Italy. FAU - Reni, Gianluigi AU - Reni G AUID- ORCID: 0000-0003-0822-3287 AD - Scientific Institute, IRCCS "E. Medea", Bioengineering Laboratory, Bosisio Parini, Lecco, Italy. FAU - Castelli, Enrico AU - Castelli E AUID- ORCID: 0000-0003-1685-8936 AD - Bambino Gesu Children's Hospital, Neurosciences and Neurorehabilitation, Rome, Italy. FAU - Frascarelli, Flaminia AU - Frascarelli F AD - Bambino Gesu Children's Hospital, Neurosciences and Neurorehabilitation, Rome, Italy. FAU - Colazza, Alessandra AU - Colazza A AD - Bambino Gesu Children's Hospital, Neurosciences and Neurorehabilitation, Rome, Italy. FAU - Cordone, Giampietro AU - Cordone G AD - Bambino Gesu Children's Hospital, Neurosciences and Neurorehabilitation, Rome, Italy. FAU - Biffi, Emilia AU - Biffi E AUID- ORCID: 0000-0002-2568-9735 AD - Scientific Institute, IRCCS "E. Medea", Bioengineering Laboratory, Bosisio Parini, Lecco, Italy. LA - eng PT - Journal Article DEP - 20200515 PL - United States TA - Biomed Res Int JT - BioMed research international JID - 101600173 SB - IM MH - Adolescent MH - Brain Injuries/physiopathology/therapy MH - Cerebral Palsy/physiopathology/therapy MH - Child MH - Differential Threshold MH - *Exercise Therapy/methods/statistics & numerical data MH - Female MH - Gait/*physiology MH - Humans MH - Male MH - Motor Disorders/physiopathology/*therapy MH - Motor Skills/physiology MH - Retrospective Studies MH - Robotics/methods MH - *Treatment Outcome MH - Walk Test PMC - PMC7246400 COIS- The authors declare that there is no conflict of interest. EDAT- 2020/06/09 06:00 MHDA- 2021/03/26 06:00 PMCR- 2020/05/15 CRDT- 2020/06/09 06:00 PHST- 2019/12/09 00:00 [received] PHST- 2020/02/18 00:00 [revised] PHST- 2020/04/22 00:00 [accepted] PHST- 2020/06/09 06:00 [entrez] PHST- 2020/06/09 06:00 [pubmed] PHST- 2021/03/26 06:00 [medline] PHST- 2020/05/15 00:00 [pmc-release] AID - 10.1155/2020/2794036 [doi] PST - epublish SO - Biomed Res Int. 2020 May 15;2020:2794036. doi: 10.1155/2020/2794036. eCollection 2020.