Department of Occupational Therapy and Graduate Institute of Clinical Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Arch Phys Med Rehabil. 2011 Aug;92(8):1281-7. doi: 10.1016/j.apmr.2011.03.008.
To determine the responsiveness, minimal detectable change (MDC), and minimal clinically important differences (MCIDs) of the Nottingham Extended Activities of Daily Living (NEADL) scale and to assess percentages of patients' change scores exceeding the MDC and MCID after stroke rehabilitation.
Secondary analyses of patients who received stroke rehabilitation therapy.
Medical centers.
Patients with stroke (N=78).
Secondary analyses of patients who received 1 of 4 rehabilitation interventions.
Responsiveness (standardized response mean [SRM]), 90% confidence that a change score at this threshold or higher is true and reliable rather than measurement error (MDC(90)), and MCID on the NEADL score and percentages of patients exceeding the MDC(90) and MCID.
The SRM of the total NEADL scale was 1.3. The MDC(90) value for the total NEADL scale was 4.9, whereas minima and maxima of the MCID for total NEADL score were 2.4 and 6.1 points, respectively. Percentages of patients exceeding the MDC(90) and MCID of the total NEADL score were 50.0%, 73.1%, and 32.1%, respectively.
The NEADL is a responsive instrument relevant for measuring change in instrumental activities of daily living after stroke rehabilitation. A patient's change score has to reach 4.9 points on the total to indicate a true change. The mean change score of a stroke group on the total NEADL scale should achieve 6.1 points to be regarded as clinically important. Our findings are based on patients with improved NEADL performance after they received specific interventions. Future research with larger sample sizes is warranted to validate these estimates.
确定诺丁汉扩展日常生活活动（NEADL）量表的反应性、最小可检测变化（MDC）和最小临床重要差异（MCID），并评估中风康复后患者的变化分数超过 MDC 和 MCID 的比例。
接受中风康复治疗的患者的二次分析。
医疗中心。
中风患者（N=78）。
对接受 4 种康复干预措施之一的患者进行二次分析。
反应性（标准化反应均值[SRM]），90%置信度表明，在这个阈值或更高的变化分数是真实和可靠的，而不是测量误差（MDC（90）），以及 NEADL 分数的 MCID 和超过 MDC（90）和 MCID 的患者比例。
总 NEADL 量表的 SRM 为 1.3。总 NEADL 量表的 MDC（90）值为 4.9，而 MCID 的最小值和最大值分别为 2.4 和 6.1 分。超过总 NEADL 分数的 MDC（90）和 MCID 的患者比例分别为 50.0%、73.1%和 32.1%。
NEADL 是一种反应灵敏的工具，适用于测量中风康复后工具性日常生活活动的变化。患者的变化分数必须达到总分数的 4.9 分，才能表明有真正的变化。中风组总 NEADL 量表的平均变化分数应达到 6.1 分，才能被认为具有临床意义。我们的发现基于接受特定干预后 NEADL 表现有所改善的患者。需要更大样本量的进一步研究来验证这些估计。
