title: Estimating the minimal clinically important difference of the Stroke Rehabilitation Assessment of Movement measure.
abstract: BACKGROUND
  The minimal clinically important difference (MCID) of the Stroke Rehabilitation Assessment of Movement (STREAM) measure is unknown, which limits the application and interpretation of change scores.
  
  
  OBJECTIVE
  To estimate the MCID of the 3 subscales (ie, lower extremity, upper extremity, and mobility subscales) of the STREAM using the method of patients' global ratings of change.
  
  
  METHODS
  Eighty-one stroke patients participated in this study. The patients' global ratings of change were used to rate their changes of limb movements and basic mobility skills on the 15-point Likert scale. The mean change scores on the 3 subscales of STREAM of the MCID group (ie, scored on +2 to +3 or -2 to -3) served as the estimates of the MCID.
  
  
  RESULTS
  There were 42, 38, and 43 patients in the MCID group, and the estimates of the MCID were 2.2, 1.9, and 4.8 points for the upper-extremity subscale, lower-extremity subscale, and mobility subscale, respectively.
  
  
  CONCLUSIONS
  These findings suggest that if the mean change scores on the 3 subscales of the STREAM within a stroke group have reached 2.2, 1.9, and 4.8 points, the change scores on the 3 subscales of the STREAM can be perceived by patients as clinically important.
authors.affiliation: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Hsieh
authors.forename: Chun-Hou
authors.initials: CH
authors.lastname: Wang
authors.forename: Ching-Fan
authors.initials: CF
authors.lastname: Sheu
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Hsueh
authors.forename: Ching-Lin
authors.initials: CL
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D009788:Occupational Therapy / Q000379:methods*; D011597:Psychomotor Performance; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013624:Taiwan; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology