Medicine and Rehabilitation Centre of Alcoitão, Santa Casa da Misericórdia de Lisboa, Lisbon, Portugal.
Rehabilitation Centre of the North, Centro Hospitalar de Vila Nova de Gaia-Espinho, Porto, Portugal.
Phys Ther. 2021 Feb 4;101(2). doi: 10.1093/ptj/pzaa210.
The objective of this study was to determine the minimal clinically important differences (MCIDs) for the numerical pain rating scale (NPRS), peak cough flow (PCF), peak expiratory flow (PEF), fatigue severity scale (FSS), and London chest activities of daily living scale (LCADL) in patients with spinal cord injuries (SCIs) after rehabilitation.
Inpatients with SCI from 2 rehabilitation centers participating in a daily rehabilitation program were recruited. The NPRS, PCF, PEF, FSS, and LCADL were collected at baseline and discharge. The global rating of change scale was performed at discharge. MCIDs were calculated using anchor (linear regression, mean change, and receiver operating characteristic curves) and distribution-based methods (0.5 times the baseline SD, standard error of measurement, 1.96 times standard error of measurement, and minimal detectable change) and pooled using arithmetic weighted mean.
Sixty inpatients with SCI (36 males; 54.5 [15.9] years) participated. On average their rehabilitation program lasted 7.3 (1.7) weeks. Pooled MCID estimates were 1.6 points for the NPRS, 69.8 L/min for the PCF, 77.4 L/min for the PEF, 1.1 points for the FSS, and 1.4 points for the LCADL.
Established MCIDs for NPRS, PCF, PEF, FSS, and LCADL will help health professionals to interpret results and guide rehabilitation interventions in patients with SCI.
Health professionals and researchers may now use -1.6 points for the NPRS, 69.8 L/min for the PCF, 77.4 L/min for the PEF, 1.1 points for the FSS, and 1.4 points for the LCADL to interpret if changes in pain, cough intensity, expiratory flow, fatigue and activities of daily living after rehabilitation of patients with SCI have been clinically relevant.
本研究旨在确定康复后脊髓损伤（SCI）患者数字疼痛评分量表（NPRS）、峰值咳嗽流量（PCF）、呼气峰值流量（PEF）、疲劳严重程度量表（FSS）和伦敦胸部日常生活活动量表（LCADL）的最小临床重要差异（MCID）。
从参与日常康复计划的 2 个康复中心招募 SCI 住院患者。在基线和出院时收集 NPRS、PCF、PEF、FSS 和 LCADL。在出院时进行总体变化等级评定。使用锚定（线性回归、平均变化和受试者工作特征曲线）和基于分布的方法（基线标准差的 0.5 倍、测量标准误差、1.96 倍测量标准误差和最小可检测变化）计算 MCID，并使用算术加权平均值进行汇总。
共有 60 名 SCI 住院患者（36 名男性；54.5[15.9]岁）参与。平均康复计划持续 7.3（1.7）周。汇总的 MCID 估计值分别为 NPRS 1.6 分、PCF 69.8 L/min、PEF 77.4 L/min、FSS 1.1 分和 LCADL 1.4 分。
为 NPRS、PCF、PEF、FSS 和 LCADL 建立的 MCID 将帮助卫生专业人员解释结果并指导 SCI 患者的康复干预。
现在，卫生专业人员和研究人员可以使用 NPRS 为-1.6 分、PCF 为 69.8 L/min、PEF 为 77.4 L/min、FSS 为 1.1 分和 LCADL 为 1.4 分，来解释康复后 SCI 患者疼痛、咳嗽强度、呼气流量、疲劳和日常生活活动的变化是否具有临床意义。
