Minimal Detectable Change for Motor Function Tests in Patients with Knee          Osteoarthritis

Background. The Wolf Motor Function Test (WMFT) is an impairment-based test whose psychometrics have been examined by previous reliability and validity studies. Standards for evaluating whether a given change is meaningful, however, have not yet been addressed. Objectives. To determine the standard error of measurement (SEM) and minimal detectable change (MDC) for the WMFT. Methods. Data were collected from 6 university laboratories that participated in the EXCITE national clinical trial and included 96 individuals with sub-acute stroke (3—9 months). Measurements were made by blinded evaluators who were trained and standardized to administer the WMFT, which was completed on 2 occasions 2 weeks apart. No intervention was given between testing sessions. Results. The WMFT Performance Time score has a SEM of 0.2 seconds and a MDC95 of 0.7 seconds. The individual task timed items MDC 95 ranged from 1.0 second (turn key in lock) to 3.4 seconds (reach and retrieve) with individual task items demonstrating notablly higher variability than the average WMFT Performance Time. The average WMFT Functional Ability Scale SEM and MDC95 is 0.1 points. Conclusions. When assessing the effect of a therapeutic intervention, if an individual experiences an amount of change equal to or greater than the MDC, then one may be 95% confident that this margin of change is truly larger than measurement error and not a chance result. Thus, the determination of SEM and MDC in outcome assessments allows researchers and clinicians to distinguish which results are actual differences versus which results are simply changes resulting from error or chance.

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Minimal Detectable Change in Quadriceps Strength and Voluntary Muscle Activation in Patients With Knee Osteoarthritis

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2010.06.002 ◽

2010 ◽

Vol 91 (9) ◽

pp. 1447-1451 ◽

Cited By ~ 58

Author(s):

Crystal O. Kean ◽

Trevor B. Birmingham ◽

S. Jayne Garland ◽

Dianne M. Bryant ◽

J. Robert Giffin

Keyword(s):

Knee Osteoarthritis ◽

Muscle Activation ◽

Quadriceps Strength ◽

Minimal Detectable Change ◽

Detectable Change ◽

Voluntary Muscle

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Minimal Detectable Change in Quadriceps Strength and Voluntary Muscle Activation in Patients With Knee Osteoarthritis

Yearbook of Sports Medicine ◽

10.1016/j.yspm.2011.01.006 ◽

2011 ◽

Vol 2011 ◽

pp. 294-295

Author(s):

M.R. Pierrynowski

Keyword(s):

Knee Osteoarthritis ◽

Muscle Activation ◽

Quadriceps Strength ◽

Minimal Detectable Change ◽

Detectable Change ◽

Voluntary Muscle

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Test-retest Reliability and Minimum Detectable Change of 2-Minute Walk Test among Individuals with Knee Osteoarthritis

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49079.15142 ◽

2021 ◽

Author(s):

Shefally ChaudHary ◽

Ammar Suhail

Keyword(s):

Knee Osteoarthritis ◽

Rating Scale ◽

Measurement Properties ◽

Minimal Detectable Change ◽

Walk Test ◽

Detectable Change ◽

Retest Reliability ◽

Walking Capacity ◽

Test Retest Reliability ◽

Minute Walk

Introduction: The 2-Minute Walk Test (2MWT) is a simple, practical, and less time consuming test. Patients do not get fatigued while performing this test as a part of routine physical examination. 2MWT shows an excellent correlation with other walk tests and can be used as an alternative test in patients with multiple co- morbidities. The reliability of a test is a must for its recommendation to be used in clinics as well as research. Measurement properties have been reported in different populations for 2MWT. However, no data exist for 2MWT in patients with Knee Osteoarthritis (KOA). Aim: To establish the test-retest reliability and Minimal Detectable Change (MDC) scores for the 2MWT in patients with bilateral KOA. Materials and Methods: A prospective test-retest research study designed to assess the reliability of 2MWT. Eighty-two patients with KOA (27 males and 55 females) were included in the study. Health status was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The Numeric Pain Rating Scale (NPRS) and WOMAC were assessed on two consecutive days. Participants performed 2MWT on two different occasions with 48 hours difference in between. Both sessions were conducted for 45 minutes each on a 30 meter walking pathway. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: 2MWT showed an excellent test-retest reliability. Intraclass Correlation Coefficient (ICC) for 2MWT were 0.98. Test-retest reliability assessed by two trials of 2MWT showed 1st trial mean±SD of 154.33±19.59 m and 2nd trial mean±SD of 156.69±19.68 m. Mean difference±SD between both trials was 2.36±2.74, which was statistically significant (p<0.001). The Standard Error of Measurement (SEM) and Minimal Detectable Change at 95% confidence level (MDC95) for 2MWT were 2.76 and 5.52 meters, respectively. Conclusion: The study recommends that 2MWT can be used as a test for assessing walking capacity among patients with KOA. A change of more than 5.52 meters can be considered as change-free of error. It can be used as an alternative to 6MWT in patients with KOA who cannot tolerate a higher duration/intensity walk test.

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Minimal Detectable Change and Clinically Important Difference of the Wolf Motor Function Test in Stroke Patients

Neurorehabilitation and Neural Repair ◽

10.1177/1545968308331144 ◽

2009 ◽

Vol 23 (5) ◽

pp. 429-434 ◽

Cited By ~ 92

Author(s):

Keh-chung Lin ◽

Yu-wei Hsieh ◽

Ching-yi Wu ◽

Chia-ling Chen ◽

Yuh Jang ◽

...

Keyword(s):

Motor Function ◽

Change Score ◽

Minimal Detectable Change ◽

Detectable Change ◽

Change Scores ◽

Real Change ◽

Function Test ◽

Before And After ◽

Wolf Motor Function Test ◽

Stroke Group

Objectives. This study aimed to establish the minimal detectable change (MDC) and clinically important differences (CID) of the Wolf Motor Function Test (WMFT) in patients with stroke, and to assess the proportions of patients' change scores exceeding the MDC and CID after stroke rehabilitation. Methods. A total of 57 patients received 1 of the 3 treatments for 3 weeks and underwent clinical assessments before and after treatment. The MDC, at 90% confidence (MDC 90), was calculated from the standard error of measurement to indicate a real change for individual patients. Anchor-based and distribution-based approaches were used to triangulate the values of minimal CID. The percentages of patients exceeding the MDC and minimal CID were also examined. Results. The MDC90 of the WMFT was 4.36 for the performance time (WMFT time) and 0.37 for the functional ability scale (WMFT FAS). The minimal CID ranged from 1.5 to 2 seconds on the WMFT time and from 0.2 to 0.4 points on the WMFT FAS. The MDC and CID proportions ranged from 14% to 30% on the WMFT time and from 39% to 65% on the WMFT FAS, respectively. Conclusions. The change score of an individual patient has to reach 4.36 and 0.37 on the WMFT time and WMFT FAS to indicate a real change. The mean change scores of a stroke group on the WMFT time and WMFT FAS should achieve 1.5 to 2 seconds and 0.2 to 0.4 points to be regarded as clinically important changes. Furthermore, the WMFT FAS may be more responsive than the WMFT time based on the results of proportions exceeding the threshold criteria.

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A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke

Clinical Rehabilitation ◽

10.1177/02692155211025131 ◽

2021 ◽

pp. 026921552110251

Author(s):

Marla K Beauchamp ◽

Rudy Niebuhr ◽

Patricia Roche ◽

Renata Kirkwood ◽

Kathryn M Sibley

Keyword(s):

Stroke Rehabilitation ◽

Minimal Clinically Important Difference ◽

Clinical Importance ◽

Minimal Detectable Change ◽

Global Rating ◽

Detectable Change ◽

Clinically Important Difference ◽

Before And After ◽

Small Change ◽

A Prospective Study

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals’ post-stroke. Design: Prospective cohort study. Setting: Outpatient stroke rehabilitation. Subjects: Fifty outpatients with stroke with a mean (SD) age of 60.8 (9.4). Intervention: Outpatients with stroke were assessed with the Mini-BESTest before and after a course of conventional rehabilitation. Rehabilitation sessions occurred one to two times/week for one hour and treatment duration was 1.3–42 weeks (mean (SD) = 17.4(10.6)). Main measures: We used a combination of anchor- and distribution-based approaches including a global rating of change in balance scale completed by physiotherapists and patients, the minimal detectable change with 95% confidence, and the optimal cut-point from receiver operating characteristic curves. Results: The average (SD) Mini-BESTest score at admission was 18.2 (6.5) and 22.4 (5.2) at discharge (effect size: 0.7) ( P = 0.001). Mean change scores on the Mini-BESTest for patient and physiotherapist ratings of small change were 4.2 and 4.3 points, and 4.7 and 5.3 points for substantial change, respectively. The minimal detectable change with 95% confidence for the Mini-BESTest was 3.2 points. The minimally clinical importance difference was determined to be 4 points for detecting small changes and 5 points for detecting substantial changes. Conclusions: A change of 4–5 points on the Mini-BEST is required to be perceptible to clinicians and patients, and beyond measurement error. These values can be used to interpret changes in balance in stroke rehabilitation research and practice.

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Strain Elastography and Tendon Response to an Exercise Program in Patients With Supraspinatus Tendinopathy: An Exploratory Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120965185 ◽

2020 ◽

Vol 8 (12) ◽

pp. 232596712096518

Author(s):

Karen Brage ◽

Birgit Juul-Kristensen ◽

John Hjarbaek ◽

Eleanor Boyle ◽

Per Kjaer ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Structural Changes ◽

Supraspinatus Tendon ◽

Patient Reported Outcome ◽

Minimal Detectable Change ◽

Detectable Change ◽

Tendon Stiffness ◽

Patient Reported ◽

Tendon Thickness

Background: Shoulder pain is common, with a lifetime prevalence of up to 67%. Evidence is conflicting in relation to imaging findings and pain in the shoulder. Sonoelastography can be used to estimate tissue stiffness and may be a clinically relevant technique for diagnosing and monitoring tendon healing. Purpose: To evaluate changes in supraspinatus tendon stiffness using strain elastography (SEL) and associations with changes in patient-reported outcomes, supraspinatus tendon thickness, and grade of tendinopathy after 12 weeks of unilateral shoulder exercises in patients with supraspinatus tendinopathy. Study Design: Controlled laboratory study. Methods: A total of 23 patients with unilateral clinical supraspinatus tendinopathy performed 12 weeks of “standard care” exercises. At baseline and follow-up, supraspinatus tendon stiffness was measured bilaterally using SEL and compared with tendinopathy grading on magnetic resonance imaging scans and tendon thickness measured using conventional ultrasound. Patient-reported outcome measures included physical function and symptoms from the Disabilities of the Arm, Shoulder and Hand questionnaire and pain rating (visual analog scale). Results: No significant changes in SEL within or between groups (asymptomatic vs symptomatic tendon) were seen. All patient-reported outcomes showed significant improvement from baseline to follow-up, but with no change in tendinopathy grading and tendon thickness. No significant differences in the proportion of patients changing above the minimal detectable change in SEL and PROM were seen, except for discomfort while sleeping. Conclusion: Despite no significant within-group or between-group changes in SEL, significant improvements were found in patient-reported outcomes. An acceptable agreement between patients changing above the minimal detectable change in SEL and patient-reported outcome measure was seen. Further studies should explore the use of SEL to detect changes after tendon repair and long-term training potentially in subgroups of different tendinopathy phases. Clinical Relevance: In the short term, structural changes in supraspinatus tendons could not be visualized using SEL, indicating that a longer time span should be expected in order to observe structural changes, which should be considered before return to sports. Subgrouping based on stage of tendinopathy may also be important in order to evaluate changes over time with SEL among patients with supraspinatus tendinopathy. Registration: NCT03425357 ( ClinicalTrials.gov identifier).

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The Igbo Brief Illness Perceptions Questionnaire: A cross-cultural adaptation and validation study in Nigerian populations with chronic low back pain

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-191687 ◽

2021 ◽

pp. 1-13

Author(s):

Chinonso N. Igwesi-Chidobe ◽

Isaac O. Sorinola ◽

Emma L. Godfrey

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Cultural Adaptation ◽

Illness Perceptions ◽

Cross Cultural ◽

Minimal Detectable Change ◽

Low Back ◽

Detectable Change ◽

Cross Cultural Adaptation

BACKGROUND: Illness perceptions predict chronic low back pain (CLBP) disability. This study cross-culturally adapted and validated the Igbo Brief Illness Perceptions Questionnaire (Igbo-BIPQ) in people with CLBP in rural/urban Nigeria. METHODS: A cross-cultural adaptation and validation of the Igbo-BIPQ was undertaken. The BIPQ was forward/back-translated by clinical/non-clinical translators. An expert review committee appraised the translations. The questionnaire was pre-tested on twelve rural Nigerian dwellers with CLBP. Internal consistency using Cronbach’s alpha; test-retest reliability using intra-class correlation coefficient and Bland-Altman plot; and minimal detectable change were investigated amongst 50 people with CLBP in rural and urban Nigeria. Construct validity was determined by correlating the Igbo-BIPQ score with those of eleven-point box scale and Igbo Roland Morris Disability Questionnaire (Igbo-RMDQ) using Pearson’s correlation analyses in 200 adults with CLBP in rural Nigeria. Ceiling and floor effects were investigated in both samples. RESULTS: Good face/content validity, internal consistency (α= 0.76) and intraclass correlation coefficient (ICC = 0.78); standard error of measurement and minimal detectable change of 5.44 and 15.08 respectively; moderate correlations with pain intensity and self-reported disability (r⩾ 0.4); no ceiling/floor effects were observed for Igbo-BIPQ. CONCLUSION: This study provides evidence of some aspects of validity and reliability of the Igbo-BIPQ.

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Minimum Detectable Change of Visual Acuity Measurements Using ETDRS Charts (Early Treatment Diabetic Retinopathy Study)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157876 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7876

Author(s):

María Carmen Sánchez-González ◽

Raquel García-Oliver ◽

José-María Sánchez-González ◽

María-José Bautista-Llamas ◽

José-Jesús Jiménez-Rejano ◽

...

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Early Treatment ◽

High Reliability ◽

Minimal Detectable Change ◽

High Contrast ◽

Detectable Change ◽

Low Contrast ◽

Minimum Detectable Change ◽

The Mean

In our work, we determined the value of visual acuity (VA) with ETDRS charts (Early Treatment Diabetic Retinopathy Study). The purpose of the study was to determine the measurement reliabilities, calculating the correlation coefficient interclass (ICC), the value of the error associated with the measure (SEM), and the minimal detectable change (MDC). Forty healthy subjects took part. The mean age was 23.5 ± 3.1 (19 to 26) years. Visual acuities were measured with ETDRS charts (96% ETDRS chart nº 2140) and (10% SLOAN Contrast Eye Test chart nº 2153). The measurements were made (at 4 m) under four conditions: Firstly, photopic conditions with high contrast (HC) and low contrast (LC) and after 15 min of visual rest, mesopic conditions with high and low contrast. Under photopic conditions and high contrast, the ICC = 0.866 and decreased to 0.580 when the luminosity and contrast decreased. The % MDC in the four conditions was always less than 10%. It was minor under photopic conditions and HC (5.83) and maximum in mesopic conditions and LC (9.70). Our results conclude a high reliability of the ETDRS test, which is higher in photopic and high contrast conditions and lower when the luminosity and contrast decreases.

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