Negahban Hossein, Monjezi Saeideh, Mehravar Mohammad, Mostafaee Neda, Shoeibi Ali
Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
J Bodyw Mov Ther. 2018 Apr;22(2):502-510. doi: 10.1016/j.jbmt.2017.06.008. Epub 2017 Jun 16.
Evaluating responsiveness has an important role in design and interpretation of the interventional studies. The aim was to estimate the responsiveness and minimally important difference (MID) of postural performance measures following balance rehabilitation in patients with Multiple Sclerosis (MS, n = 38).
Postural measures were evaluated at baseline and after 4 weeks intervention. Laboratory-based measures were center of pressure parameters. Clinically-based measures were Activities-specific Balance Confidence (ABC), Berg Balance Scale (BBS), Functional Gait Assessment (FGA); and walking measures 2 Minute Walk (2 MW), 10 Meter Timed Walk (10 MTW) and Timed Up and Go (TUG) performed under single and dual-task conditions. To evaluate responsiveness, we calculated the Receiver Operating Characteristics (ROC) and the Area Under the ROC Curve (AUC). The optimal values for the MID were the cutoffs corresponding to the upper left corner of the ROC curve.
The AUCs for mean and standard deviation of sway velocity were above the cutoff of 0.50 in most conditions. For the clinically-based measures, the highest AUCs were found for the ABC, and cognitive-2MW, followed by the BBS and 10 MTW.
In this preliminary study, the most appropriate postural performance measures and the MID values for detecting meaningful changes in MS undergoing balance rehabilitation have been provided.
评估反应性在干预性研究的设计和解释中具有重要作用。目的是评估多发性硬化症（MS，n = 38）患者平衡康复后姿势性能测量的反应性和最小重要差异（MID）。
在基线和4周干预后评估姿势测量。基于实验室的测量是压力中心参数。基于临床的测量是特定活动平衡信心（ABC）、伯格平衡量表（BBS）、功能性步态评估（FGA）；以及在单任务和双任务条件下进行的步行测量2分钟步行（2MW）、10米定时步行（10MTW）和定时起立行走（TUG）。为了评估反应性，我们计算了受试者工作特征（ROC）和ROC曲线下面积（AUC）。MID的最佳值是对应于ROC曲线左上角的截断值。
在大多数情况下，摇摆速度的平均值和标准差的AUC高于0.50的截断值。对于基于临床的测量，ABC和认知2MW的AUC最高，其次是BBS和10MTW。
在这项初步研究中，提供了用于检测接受平衡康复的MS中有意义变化的最合适的姿势性能测量和MID值。
