Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Family Medicine and Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Spinal Cord. 2023 Dec;61(12):652-657. doi: 10.1038/s41393-023-00934-x. Epub 2023 Sep 26.
Retrospective cohort study.
To find minimal clinically important difference (MCID) and minimal detectable change (MDC) of Spinal Cord Ability Ruler (SCAR) in Thai participants with spinal cord injury (SCI).
Rehabilitation ward at Maharaj Nakorn Chiang Mai Hospital.
Data of individuals with SCI who were not diagnosed with central cord syndrome and were admitted for the first time for rehabilitation were analyzed. Upper extremities motor score, self-care and mobility items of Spinal Cord Independence Measure version III were collected and used to calculate SCAR difference between data on date of admission and discharge. MCID and MDC were calculated by distribution-based method and categorized for each subgroup according to SCI characteristics.
From data of 311 individuals, MCID of SCAR is approximately 4 for individual with tetraplegia AIS A, B, C; and individual with AIS D at any level, and 2 for individual with paraplegia AIS A, B, C. MDC of SCAR should be 1 for individual with tetraplegia AIS A, B, C; and individual with AIS D at any level and 0.5 for individual with paraplegia AIS A, B, C.
This study provides MCID and MDC of SCAR in each subgroup. These values could be used as a benchmark for clinicians and researchers to determine whether participant has significant improvement or not after receiving an intervention.
回顾性队列研究。
在泰国脊髓损伤(SCI)患者中寻找脊髓能力标尺(SCAR)的最小临床重要差异(MCID)和最小可检测变化(MDC)。
玛哈沙拉堪清迈医院康复病房。
分析首次入院接受康复治疗且未诊断为中央脊髓综合征的 SCI 患者的数据。收集上肢运动评分、脊髓独立性测量第三版的自理和移动项目,并用于计算入院和出院时 SCAR 差异。通过基于分布的方法计算 MCID 和 MDC,并根据 SCI 特征对每个亚组进行分类。
从 311 名患者的数据中得出,四肢瘫痪 AIS A、B、C 的个体以及任何水平的 AIS D 的个体的 SCAR MCID 约为 4,而 AIS A、B、C 的个体的 SCAR MCID 约为 2。四肢瘫痪 AIS A、B、C 的个体以及任何水平的 AIS D 的个体的 SCAR MDC 应为 1,而 AIS A、B、C 的个体的 SCAR MDC 应为 0.5。
本研究提供了每个亚组中 SCAR 的 MCID 和 MDC。这些值可作为临床医生和研究人员的基准,用于确定患者在接受干预后是否有显著改善。