PMID- 34247469
OWN - NLM
STAT- MEDLINE
DCOM- 20211222
LR  - 20211222
IS  - 1973-9095 (Electronic)
IS  - 1973-9087 (Linking)
VI  - 57
IP  - 6
DP  - 2021 Dec
TI  - Minimal clinically important difference of Gait Assessment and Intervention Tool 
      (GAIT) in patients with sub-acute stroke.
PG  - 874-878
LID - 10.23736/S1973-9087.21.06735-6 [doi]
AB  - BACKGROUND: The Gait Assessment and Intervention Tool (GAIT) is a well-accepted 
      tool to determine gait characteristics in neurological patients. AIM: The aim of 
      this study was to determine the minimal clinically importance difference (MCID) 
      of the GAIT in sub-acute stroke patients. DESIGN: Prospective study. SETTING: An 
      in- and out-patient rehabilitation clinic in a university hospital in Thailand. 
      POPULATION: Patients with sub-acute stroke who had an ongoing rehabilitation 
      between October 2017 to March 2019. METHODS: We used an anchor-based method to 
      determine change in GAIT score needed to achieve MCID. Participants were 
      dichotomized to 'no change group' or 'positive change group' based on different 
      anchors of objective and subjective perceived changes in gait function after 4 
      weeks of rehabilitation. The groups were determined based on whether 1) 
      participants achieved an increase in comfortable gait speed (CGS) of >/= 0.06 m/s, 
      2) averaged Global Rating of Change (GROC) score was >/=+3 evaluated by two 
      physiatrists 3) GROC score of was >/=+3 rated by the participants. The best cut-off 
      point was the score which most successfully separated these two groups within the 
      ROC curve. RESULTS: Thirty-one participants with sub-acute stroke (18 males, 13 
      female) completed both assessments. Their average age was 60.3+/-11.4 years. The 
      best cut-off point were a 2.5- and 4-point improvements in GAIT score based on 
      changes in CGS (AUC 0.76, 95% CI 0.58-0.95) and clinicians' perceived changes 
      (AUC 0.88, 95% CI 0.76-1.00). Additionally, the best cut-off point was 1.5 (AUC 
      0.71 95% CI 0.31-1.00) when determined by participants' perception. All anchors 
      yielded adequate discriminative ability. The positive likelihood ratio (LR) was 
      in the range of 2.7-5.5 and the negative LR range was 0.1-0.3. CONCLUSIONS: A 
      change in GAIT score should exceed 1.5, 2.5 and 4 to be considered MCID based on 
      participants' GROC, CGS and Clinicians' GROC anchors. CLINICAL REHABILITATION 
      IMPACT: This information will be useful for the determination of changes after 
      rehabilitation and for tracking sub-acute stroke patients' progress.
FAU - Saengsuwan, Jittima
AU  - Saengsuwan J
AD  - Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, 
      Khon Kaen, Thailand.
AD  - North-eastern Stroke Research Group, Khon Kaen University, Khon Kaen, Thailand.
FAU - Vichiansiri, Ratana
AU  - Vichiansiri R
AD  - Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, 
      Khon Kaen, Thailand - vratana@kku.ac.th.
LA  - eng
PT  - Journal Article
DEP - 20210712
PL  - Italy
TA  - Eur J Phys Rehabil Med
JT  - European journal of physical and rehabilitation medicine
JID - 101465662
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Prospective Studies
MH  - *Stroke/complications/diagnosis
MH  - Walking Speed
EDAT- 2021/07/13 06:00
MHDA- 2021/12/24 06:00
CRDT- 2021/07/12 03:59
PHST- 2021/07/13 06:00 [pubmed]
PHST- 2021/12/24 06:00 [medline]
PHST- 2021/07/12 03:59 [entrez]
AID - S1973-9087.21.06735-6 [pii]
AID - 10.23736/S1973-9087.21.06735-6 [doi]
PST - ppublish
SO  - Eur J Phys Rehabil Med. 2021 Dec;57(6):874-878. doi: 
      10.23736/S1973-9087.21.06735-6. Epub 2021 Jul 12.