scholarly journals Minimal Detectable Change of the Timed “Up & Go” Test and the Dynamic Gait Index in People With Parkinson Disease

2011 ◽  
Vol 91 (1) ◽  
pp. 114-121 ◽  
Author(s):  
Sheau-Ling Huang ◽  
Ching-Lin Hsieh ◽  
Ruey-Meei Wu ◽  
Chun-Hwei Tai ◽  
Chin-Hsien Lin ◽  
...  

Background The minimal detectable change (MDC) is the smallest amount of difference in individual scores that represents true change (beyond random measurement error). The MDCs of the Timed “Up & Go” Test (TUG) and the Dynamic Gait Index (DGI) in people with Parkinson disease (PD) are largely unknown, limiting the interpretability of the change scores of both measures. Objective The purpose of this study was to estimate the MDCs of the TUG and the DGI in people with PD. Design This investigation was a prospective cohort study. Methods Seventy-two participants were recruited from special clinics for movement disorders at a university hospital. Their mean age was 67.5 years, and 61% were men. All participants completed the TUG and the DGI assessments twice, about 14 days apart. The MDC was calculated from the standard error of measurement. The percentage MDC (MDC%) was calculated as the MDC divided by the mean of all scores for the sample. Furthermore, the intraclass correlation coefficient was used to examine the reproducibility between testing sessions (test-retest reliability). Results The respective MDC and MDC% of the TUG were 3.5 seconds and 29.8, and those of the DGI were 2.9 points and 13.3. The test-retest reliability values for the TUG and the DGI were high; the intraclass correlation coefficients were .80 and .84, respectively. Limitations The study sample was a convenience sample, and the participants had mild to moderately severe PD. Conclusions The results showed that the TUG and the DGI have generally acceptable random measurement error and test-retest reliability. These findings should help clinicians and researchers determine whether a change in an individual patient with PD is a true change.

2021 ◽  
Author(s):  
A Wallin ◽  
M Kierkegaard ◽  
E Franzén ◽  
S Johansson

Abstract Objective The mini-BESTest is a balance measure for assessment of the underlying physiological systems for balance control in adults. Evaluations of test–retest reliability of the mini-BESTest in larger samples of people with multiple sclerosis (MS) are lacking. The purpose of this study was to investigate test–retest reliability of the mini-BESTest total and section sum scores and individual items in people with mild to moderate overall MS disability. Methods This study used a test–retest design in a movement laboratory setting. Fifty-four people with mild to moderate overall MS disability according to the Expanded Disability Status scale (EDSS) were included, with 28 in the mild subgroup (EDSS 2.0–3.5) and 26 in the moderate subgroup (EDSS 4.0–5.5). Test–retest reliability of the mini-BESTest was evaluated by repeated measurements taken 1 week apart. Reliability and measurement error were analyzed. Results Test–retest reliability for the total scores were considered good to excellent, with intraclass correlation coefficients of .88 for the whole sample, .83 for the mild MS subgroup, and .80 for the moderate MS subgroup. Measurement errors were small, with standard error of measurement and minimal detectable change of 1.3 and 3.5, respectively, in mild MS, and 1.7 and 4.7, respectively, in moderate MS. The limits of agreement were − 3.4 and 4.6. Test–retest reliability for the section scores were fair to good or excellent; weighted kappa values ranged from .62 to .83. All items but 1 showed fair to good or excellent test–retest reliability, and percentage agreement ranged from 61% to 100%. Conclusions The mini-BESTest demonstrated good to excellent test–retest reliability and small measurement errors and is recommended for use in people with mild to moderate MS. Impact Knowledge of limits of agreement and minimal detectable change contribute to interpretability of the mini-BESTest total score. The findings of this study enhance the clinical usefulness of the test for evaluation of balance control and for designing individually customized balance training with high precision and accuracy in people with MS.


2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27 ◽  
Author(s):  
Kitima Rongsawad ◽  
Laddawon Worawan ◽  
Karnsiree Jirarojprapa ◽  
Sararat Kaewkham ◽  
Sarawut Khattiwong

Abstract Introduction Static postural stability is the ability to maintain the posture with minimum sway. Increasing postural sway during standing in different sensory conditions is associated with aging due to decline in sensory and motor functions. Sway area measured by using sway meter is usually simple method for assessing postural stability in elderly subjects. Like many biological measurements, sway area has an intrinsic variability that affects their test-retest reliability and responsiveness of postural stability assessment. The minimal detectable change (MDC) is ability to detect smallest change beyond measurement error that reflects a reliable change. Therefore, the MDC value could provide information of clinical relevance on postural stability. The aims of this study were to determine test-retest reliability and MDC of sway area obtained from sway meter in elderly subjects. Methods Twelve healthy elderly subjects aged 60 years and above were participated in this study. The test and retest repeatability of postural sway measurements were performed twice with a 1-hour interval. For each subject was assess postural sway using Lord’s sway meter during standing on 4 sensory conditions for 30 seconds of each condition. The test-retest reliability of sway area was calculated using intraclass correlation coefficient. The MDC for each sway area was calculated to quantify clinical relevance. Results The test-retest reliability of sway area revealed good to excellent reliability ranged from 0.85 to 0.94. Standard error of measurement (SEM) and MDC ranged from 75 to 205 mm2 and 209 to 568 mm2, respectively. Discussion and Conclusion Our findings reveal that sway area in different sensory conditions could be used in assessment of postural stability in elderly subjects. SEM and MDC of sway area increased when subjects were asked to close their eyes and on foam surface. The sway meter is a reliable tool for assessing postural stability in clinical setting.


2020 ◽  
Vol 47 (4) ◽  
pp. 479-486
Author(s):  
Yuki Kondo ◽  
Kyota Bando ◽  
Yosuke Ariake ◽  
Wakana Katsuta ◽  
Kyoko Todoroki ◽  
...  

BACKGROUND: The reliability of the evaluation of the Balance Evaluation Systems Test (BESTest) and its two abbreviated versions are confirmed for balance characteristics and reliability. However, they are not utilized in cases of spinocerebellar ataxia (SCA). OBJECTIVE: We aimed to examine the test-retest reliability and minimal detectable change (MDC) of the BESTest and its abbreviated versions in persons with mild to moderate spinocerebellar ataxia. METHODS: The BESTest was performed in 20 persons with SCA at baseline and one month later. The scores of the abbreviated version of the BESTest were determined from the BESTest scores. The interclass correlation coefficient (1,1) was used as a measure of relative reliability. Furthermore, we calculated the MDC in the BESTest and its abbreviated versions. RESULTS: The intraclass correlation coefficients (1,1) and MDC at 95% confidence intervals were 0.92, 8.7(8.1%), 0.91, 4.1(14.5%), and 0.81, 5.2(21.6%) for the Balance, Mini-Balance, and Brief-Balance Evaluation Systems Tests, respectively. CONCLUSIONS: The BESTest and its abbreviated versions had high test-retest reliability. The MDC values of the BESTest could enable clinicians and researchers to interpret changes in the balance of patients with SCA more precisely.


2018 ◽  
Vol 20 (5) ◽  
pp. 231-237 ◽  
Author(s):  
Kathryn D. Mitchell ◽  
Han Chen ◽  
Sheri P. Silfies

Abstract Background: Individuals with multiple sclerosis (MS) have balance deficits that result in falls. Balance tests developed for older adults do not discriminate between fallers and nonfallers with MS. The Balance Evaluation Systems Test (BESTest) identifies body systems contributing to imbalance/fall risk. This study evaluated the test-retest reliability and construct validity of the BESTest to assess balance in individuals with MS, compared the diagnostic accuracy of the BESTest and Berg Balance Scale (BBS), and investigated the minimal detectable change of the BESTest in this population. Methods: Twenty individuals with MS were recruited. Age, onset of disease, and fall history were obtained. The following measures were used: Expanded Disability Status Scale, University of Illinois at Chicago Fear of Falling Measure, BESTest, and BBS. Twelve participants were retested to determine test-retest reliability of the BESTest. Results: The BESTest demonstrated strong test-retest reliability (intraclass correlation coefficient [3,1] = 0.98 [95% CI, 0.91–0.99], P = .01) and was highly correlated with the BBS (r = 0.94, P = .01). The BBS had poor accuracy to identify fallers. Using a score of 81%, the BESTest had moderate sensitivity (0.89) to identify fallers. The standard error of the measurement for the BESTest was 4.16 points, which translates into a minimal detectable change of 9.7% [90% CI] to 11.5% [95% CI]. Conclusions: The BESTest demonstrates excellent test-retest reliability and diagnostic utility as a measure of functional balance in persons with moderate MS. A change in BESTest score of at least 10% may indicate a true change in balance performance in this population.


Author(s):  
Posen Lee ◽  
Ping-Chia Li ◽  
Chin-Hsuan Liu ◽  
Hung-Yu Lin ◽  
Chien-Yu Huang ◽  
...  

Background: The Ruff 2 and 7 Selective Attention Test (RSAT) is designed to measure selective attention. It tests automatic detection speed (ADS), automatic detection errors (ADE), automatic detection accuracy (ADA), controlled search speed (CSS), controlled search errors (CSE), and controlled search accuracy (CSA). The purpose of this study was to examine the test–retest reliability, practice effect, and minimum detectable change (MDC) of the RSAT in patients with schizophrenia. Methods: A total of 101 patients with schizophrenia completed the RSAT twice at a 4-week interval. The intra-class correlation coefficient (ICC), paired t test, and effect size were used to examine the test–retest reliability and practice effect. The standard error of measurement (SEM) and MDC were calculated. Results: The difference scores between the two assessments were significant in all the indexes. The absolute effect sizes were 0.14 to 0.30. The ICCs of the RSAT ranged from 0.69 to 0.91. The MDC% in the indexes of ADS, ADA, and CSA of the RSAT were <30%. Conclusions: The RSAT is reliable for assessing selective attention in patients with schizophrenia. The RSAT has good to excellent test–retest reliability, a trivial to small practice effect, and indexes of ADS, ADA, and CSA, representing acceptable random measurement error.


2020 ◽  
Vol 100 (7) ◽  
pp. 1206-1216 ◽  
Author(s):  
Andrew Sawers ◽  
Janis Kim ◽  
Geoff Balkman ◽  
Brian J Hafner

Abstract Objective A major barrier to reducing falls among users of lower limb prostheses (LLP) has been an absence of statistical indices required for clinicians to select and interpret scores from performance-based clinical tests. The study aimed to derive estimates of reliability, measurement error, and minimal detectable change values in performance-based clinical tests administered to unilateral LLP users. Methods A total of 60 unilateral LLP users were administered the Narrowing Beam Walking Test, Timed ``Up and Go'' (TUG), Four Square Step Test (FSST), and 10-Meter Walk Test on 2 occasions, 3 to 9 days apart. Intraclass correlation coefficients (ICCs) were calculated to assess interrater and test-retest reliability, while standard error of measurement (SEM) and minimal detectable change (MDC90) were derived to establish estimates of measurement error in individual scores or changes in score for each test. Results Interrater reliability ICCs (1,1) were high for all tests (ie, ≥0.98). Test-retest ICCs (2,1) varied by test, ranging from .88 for the TUG to .97 for the FSST. SEM and MDC90 varied between .39 and .96 and between .91 seconds and 2.2 seconds for the time-based tests (FSST, TUG, 10-Meter Walk Test). SEM and MDC90 for the Narrowing Beam Walking Test were .07 and .16, respectively. Conclusion With the exception of the TUG, studied tests had test-retest ICCs (2,1) that exceeded the minimum required threshold to be considered suitable for group- and individual-level applications (ie, ICC ≥ 0.70 and ≥ 0.90, respectively). Future research on individuals with dysvascular and transfemoral amputations or in specific age categories is required. Impact Along with published validity indices, these reliability, error, and change indices can help clinicians select balance tests suitable for LLP users. They can also help clinicians interpret test scores to make informed, evidence-based clinical decisions.


2021 ◽  
Vol 17 (4) ◽  
pp. 344-351
Author(s):  
Yukyeong Jung ◽  
Jae Ho Han ◽  
Seokyu Choi ◽  
Jae Hee Lee

Purpose: This study aimed to measure the test-retest reliability of the Korean Matrix sentence-in-noise test in a sound-field testing condition.Methods: Fifty-five listeners with normal hearing participated. The sound-field speech-in-noise test was administered with a front loudspeaker by presenting noise at a fixed level (65 dB SPL) while adaptively adjusting the sentence level based on the listener’s response. The speech reception thresholds (SRTs) corresponding to 50% sentence-in-noise intelligibility were obtained using speech-shaped noise (SSN), International Collegium of Rehabilitative Audiology (ICRA) noise, and International Speech Test Signal (ISTS) noise. For the test-retest reliability, each subject was tested twice in a 2-week interval. The test-retest reliabilities were judged by the intraclass correlation coefficient (ICC), the minimal detectable change (MDC) values, and Bland-Altman plots.Results: The test-retest reliabilities of the Korean Matrix sentence test were good (ICC, 0.84~0.86) across SSN, ICRA, ISTS noises. The MDC was 0.92 dB SNR for SSN and 2.83 and 2.98 dB SNR for ICRA and ISTS, indicating the random measurement error varied across the types of noise.Conclusion: The Korean Matrix sentence-in-noise test can be used as a reliable tool to assess speech-in-noise intelligibility in sound-field testing condition. Further study across various sessions would strengthen the present finding.


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Juan Pablo Martinez-Cano ◽  
Daniel Vernaza-Obando ◽  
Julián Chica ◽  
Andrés Mauricio Castro

Abstract Objective The aim of this study was to translate to Spanish the patellofemoral pain and osteoarthritis subscale of the knee injury and osteoarthritis outcome score (KOOS-PF) and validate this Spanish version of a disease-specific patient-reported outcome measure (PROM) for patellofemoral pain. Results The KOOS-PF was translated to Spanish and sixty patients with patellofemoral pain and/or osteoarthritis accepted to complete the questionnaire. 1-week later 58 patients answered the questions again for the test–retest reliability validation and finally 55 patients completed 1-month later for the responsiveness assessment. The Spanish version showed very good internal consistency (Cronbach’s alpha: 0.93) and test–retest reliability (intraclass correlation coefficient: 0.82). Responsiveness was confirmed, showing a strong correlation with the global rating of change (GROC) score (r 0.64). The minimal detectable change was 11.1 points, the minimal important change was 17.2 points, and there were no floor or ceiling effects for the score.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kuan-Wei Chen ◽  
Ya-Chen Lee ◽  
Tzu-Ying Yu ◽  
Li-Jung Cheng ◽  
Chien-Yu Chao ◽  
...  

Abstract Background Fluid intelligence deficits affect executive functioning and social behaviors in patients with schizophrenia. To help clinicians manage fluid intelligence deficits, a psychometrically sound measure is needed. The purposes of this study were to examine the test–retest reliability and convergent validity of the Test of Nonverbal Intelligence-Fourth Edition (TONI-4) assessing fluid intelligence in patients with schizophrenia. Methods A total of 103 patients with stable condition were assessed with the TONI-4 twice with a 4-week interval to examine the test–retest reliability. We further used the Montreal Cognitive Assessment (MoCA) and the Tablet-Based Symbol Digit Modalities Test (T-SDMT) to examine the convergent validity of the TONI-4. Results The intra-class correlation coefficient was 0.73 for the TONI-4. The percentages of standard error of measurement and minimal detectable change for the TONI-4 were 5.1 and 14.2%, respectively. The practice effect of the TONI-4 was small (Cohen’s d = − 0.03). Convergent validity showed small to moderate significant correlations between the TONI-4 and the MoCA as well as the T-SDMT (r = 0.35, p = .011 with the T-SDMT and r = 0.61, p < .001 with the MoCA). The results demonstrated that the TONI-4 had good test–retest reliability, limited random measurement error, and a trivial practice effect. The convergent validity of the TONI-4 was good. Conclusions These findings indicate that the TONI-4 has potential to be a reliable and valid assessment of fluid intelligence in patients with schizophrenia.


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