Lin Keh-chung, Hsieh Yu-wei, Wu Ching-yi, Chen Chia-ling, Jang Yuh, Liu Jung-sen
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Neurorehabil Neural Repair. 2009 Jun;23(5):429-34. doi: 10.1177/1545968308331144. Epub 2009 Mar 16.
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.
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.
The MDC(90) 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.
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.
本研究旨在确定中风患者Wolf运动功能测试（WMFT）的最小可检测变化（MDC）和临床重要差异（CID），并评估中风康复后患者变化分数超过MDC和CID的比例。
共有57名患者接受了3种治疗中的1种，为期3周，并在治疗前后进行了临床评估。从测量标准误差计算出90%置信度下的MDC（MDC(90)），以表明个体患者的真实变化。基于锚定法和基于分布法的方法用于确定最小CID值。还检查了超过MDC和最小CID的患者百分比。
WMFT的MDC(90)在执行时间（WMFT时间）上为4.36，在功能能力量表（WMFT FAS）上为0.37。WMFT时间的最小CID范围为1.5至2秒，WMFT FAS的最小CID范围为0.2至0.4分。WMFT时间的MDC和CID比例分别为14%至30%，WMFT FAS的MDC和CID比例分别为39%至65%。
个体患者在WMFT时间和WMFT FAS上的变化分数必须分别达到4.36和0.37，才能表明有真实变化。中风组在WMFT时间和WMFT FAS上平均变化分数应达到1.5至2秒和0.2至0.4分，才被视为具有临床重要意义的变化。此外，根据超过阈值标准的比例结果，WMFT FAS可能比WMFT时间更具反应性。
