评估前庭障碍患者平衡和步态结局测量的最小临床重要差异。

Estimating the minimal clinically important difference for balance and gait outcome measures in individuals with vestibular disorders.

机构信息

Louisiana State University Health Sciences Center, New Orleans, LA, USA.

Our Lady of the Lake Hearing and Balance Center, Baton Rouge, LA, USA.

出版信息

J Vestib Res. 2022;32(3):223-233. doi: 10.3233/VES-201630.

DOI:10.3233/VES-201630

PMID:35147571

Abstract

BACKGROUND

Vestibular Rehabilitation Therapists (VRT) utilize outcome measures to quantify gait and balance abilities in individuals with vestibular disorders (IVD). The minimal clinically important difference (MCID) in gait and balance outcome measures for IVD is unknown.

OBJECTIVE

The purpose of this study is to estimate the MCID of the Activities-specific Balance Confidence Scale (ABC), Functional Gait Assessment (FGA), and Gait Speed (GS) using distribution and anchor-based methods relative to the Dizziness Handicap Inventory (DHI) in IVD.

METHODS

Data were collected using a retrospective chart review from two outpatient Vestibular Rehabilitation (VR) clinics. Data included demographic characteristics, diagnosis, VR course, and pre and post outcome measures including DHI, ABC, FGA, and GS. The DHI was used to classify subjects as "responders" or "non-responders" in order to calculate MCID values.

RESULTS

The total number of subjects analyzed for each outcome measure was 222 for the ABC, 220 for FGA, and 237 for GS. Subjects made statistically significant improvements in ABC, DHI, FGA, and GS (p < 0.001) from pre to post VR. The MCID calculated for ABC, FGA, and GS using the anchor-based approach was 18.1%, 4 points, and 0.09 m/s respectively. The MCIDs calculated using distribution-based approach for the ABC ranged between 7.5-23.5%, FGA ranged between 1.31-4.15 points, and GS ranged between 0.07 m/s-0.22 m/s.

CONCLUSIONS

The anchor-based calculations of the MCID of 18.1%, 4 points, and 0.09 m/s for ABC, FGA, and GS respectively for IVD should be used over distribution-based calculations. This is due to strength of DHI as the anchor and statistical analysis. VRT and researches can use these values to indicate meaningful changes in gait and balance function in IVD.

摘要

背景

前庭康复治疗师（VRT）利用结局测量来量化前庭障碍（IVD）个体的步态和平衡能力。步态和平衡结局测量的最小临床重要差异（MCID）在 IVD 中尚不清楚。

目的

本研究旨在使用分布和基于锚定的方法，相对于 IVD 中的眩晕障碍量表（DHI），估计活动特异性平衡信心量表（ABC）、功能性步态评估（FGA）和步态速度（GS）的 MCID。

方法

数据通过对两家门诊前庭康复（VR）诊所的回顾性图表审查收集。数据包括人口统计学特征、诊断、VR 疗程以及包括 DHI、ABC、FGA 和 GS 在内的前后结局测量。使用 DHI 将受试者分类为“应答者”或“非应答者”，以计算 MCID 值。

结果

对于 ABC、FGA 和 GS，每个结局测量分析的受试者总数分别为 222、220 和 237。从 VR 前到 VR 后，ABC、DHI、FGA 和 GS 均有统计学意义的改善（p<0.001）。基于锚定的方法计算的 ABC、FGA 和 GS 的 MCID 分别为 18.1%、4 分和 0.09 m/s。基于分布的方法计算的 ABC 的 MCID 范围为 7.5-23.5%，FGA 的 MCID 范围为 1.31-4.15 分，GS 的 MCID 范围为 0.07 m/s-0.22 m/s。