Department of Rehabilitation, 469666Numata Neurosurgery & Heart Disease Hospital, Numata, Japan.
Department of Physical Therapy, 26294Ibaraki Prefectural University of Health Science, Inashiki-gun, Japan.
Clin Rehabil. 2022 Nov;36(11):1512-1523. doi: 10.1177/02692155221108552. Epub 2022 Jun 21.
To determine the minimal clinically important difference between the Berg Balance Scale and comfortable walking speed in acute-phase stroke patients.
Multicenter, prospective, longitudinal study.
Inpatient acute stroke rehabilitation.
Seventy-five patients with acute stroke, mean (SD) age 71.7 (12.2) years.
Inpatients with acute stroke were assessed with the Berg Balance Scale and comfortable walking speed before and after rehabilitation. Physiotherapy was conducted to improve balance and gait over a 2-week period: an average of 40 min/day on weekdays and 20 min/day on weekends and holidays.
The patients' Berg Balance Scale, comfortable walking speed, Global Rating of Change scale (patient-rated and physiotherapist-rated), and motor score of the Functional Independence Measure were obtained. Minimal clinically important differences were estimated using both anchor- (receiver operating characteristic curves and change difference) and distribution-based approaches (minimal detectable change and 0.5× the change score [SD]).
The baseline scores were 31.2 (18.9) for the Berg Balance Scale and 0.79 (0.35) m/s for comfortable walking speed. The minimal clinically important difference in the Berg Balance Scale was 6.5-12.5 points by the anchor-based approach and 2.3-4.9 points by the distribution-based approach. The minimal clinically important difference in comfortable walking speed was 0.18-0.25 m/s by the anchor-based and 0.13-0.15 m/s by the distribution-based approach.
A change of 6.5-12.5 points in the Berg Balance Scale and 0.18-0.25 m/s in the comfortable walking speed is required in these measurements' anchor-based minimal clinically important differences to be beyond measurement error, and to be perceptible by both patients and clinicians.
确定急性脑卒中患者 Berg 平衡量表与舒适步行速度之间的最小临床重要差异。
多中心、前瞻性、纵向研究。
住院急性脑卒中康复。
75 例急性脑卒中患者，平均（SD）年龄 71.7（12.2）岁。
急性脑卒中患者在康复前后分别进行 Berg 平衡量表和舒适步行速度评估。物理治疗在 2 周内改善平衡和步态：平均每周 5 天每天 40 分钟，周末和节假日每天 20 分钟。
患者 Berg 平衡量表、舒适步行速度、总体变化量表（患者自评和物理治疗师评价）和功能独立性测量的运动评分。使用基于锚定（受试者工作特征曲线和差异变化）和基于分布（最小可检测变化和 0.5×变化得分[SD]）的方法估计最小临床重要差异。
基线 Berg 平衡量表评分为 31.2（18.9）分，舒适步行速度为 0.79（0.35）m/s。基于锚定的 Berg 平衡量表最小临床重要差异为 6.5-12.5 分，基于分布的 Berg 平衡量表最小临床重要差异为 2.3-4.9 分。基于锚定的舒适步行速度最小临床重要差异为 0.18-0.25 m/s，基于分布的舒适步行速度最小临床重要差异为 0.13-0.15 m/s。
在 Berg 平衡量表和舒适步行速度的这些测量中，基于锚定的最小临床重要差异要求变化 6.5-12.5 分和 0.18-0.25 m/s，以超出测量误差，并使患者和临床医生都能感知到。
