Wu Ching-Yi, Hung Shuan-Ju, Lin Keh-Chung, Chen Kai-Hua, Chen Poyu, Tsay Pei-Kwei
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Occup Ther Int. 2019 Apr 14;2019:2517658. doi: 10.1155/2019/2517658. eCollection 2019.
Persons with stroke frequently suffer from cognitive impairment. The Montreal Cognitive Assessment (MoCA), a recently developed screening tool, is sensitive to poststroke cognitive deficits. The present study assessed its psychometric and clinimetric properties (i.e., responsiveness, minimal clinically important difference (MCID), and criterion validity) in stroke survivors receiving rehabilitative therapy.
The MoCA and the Stroke Impact Scale (SIS) were administered to 65 stroke survivors before and after 4 to 5 weeks of therapy. The effect size and standardized response mean (SRM) were calculated for responsiveness. Anchor- and distribution-based methods were used to estimate the MCID. Criterion validity was measured with the Spearman correlation coefficient.
The responsiveness of the MoCA was moderate (SRM = 0.67). Participants exceeding the MCID according to the anchor- and distribution-based approaches were 33 (50.77%) and 20 (30.77%), respectively. Fair to good concurrent validity was reported between the MoCA and the SIS communication subscale. The MoCA had satisfactory predictive validity with the SIS communication and memory subscales.
This study may support the responsiveness, MCID, and criterion validity of the MoCA in stroke populations. Future studies with larger sample sizes are needed to validate the current findings.
中风患者常伴有认知障碍。蒙特利尔认知评估量表（MoCA）是一种最近开发的筛查工具，对中风后认知缺陷敏感。本研究评估了其在接受康复治疗的中风幸存者中的心理测量和临床测量特性（即反应性、最小临床重要差异（MCID）和效标效度）。
在治疗4至5周前后，对65名中风幸存者进行MoCA和中风影响量表（SIS）评估。计算效应量和标准化反应均值（SRM）以评估反应性。采用基于锚定和分布的方法估计MCID。用Spearman相关系数测量效标效度。
MoCA的反应性中等（SRM = 0.67）。根据基于锚定和分布的方法，超过MCID的参与者分别为33人（50.77%）和20人（30.77%）。MoCA与SIS沟通子量表之间的同时效度为中等至良好。MoCA与SIS沟通和记忆子量表具有良好的预测效度。
本研究可能支持MoCA在中风人群中的反应性、MCID和效标效度。需要未来更大样本量的研究来验证当前的研究结果。
