title: Estimating the minimal clinically important difference of an upper extremity recovery measure in subacute stroke patients.
abstract: BACKGROUND
  The minimal clinically important difference (MCID) estimates of some of the stroke-related measures are available; but MCID of the Fugl-Meyer assessment (FMA) measure is unknown, which limits the application and interpretation of change scores in poststroke patients with motor deficits.
  
  
  OBJECTIVE
  To estimate the MCID of the FMA-UE (upper extremity) using the modified Rankin scale (mRS) and global rating of patient-perceived changes (GRPPC) in subacute poststroke patients.
  
  
  METHODS
  The prospective, cohort study took place in the neurology department of a university hospital. Seventy-one subacute poststroke (mean duration, 8.42 weeks) patients were prospectively enrolled in a randomized clinical trial of the ongoing Meaningful Task Specific Training (MTST). FMA-UE, mRS, and GRPPC scores were obtained at pre- and 4 weeks postintervention.
  
  
  RESULTS
  The MCID values of FMA-UE were 9 (80.39% sensitive and 70% specific) and 10 (97.62% sensitive and 89.66% specific) anchored to mRS and GRPPC, respectively.
  
  
  CONCLUSIONS
  The estimated MCID score for the upper extremity motor recovery among patients with subacute stroke is 9 to 10 on the FMA-UE. Patients with subacute stroke who achieve a score of 9 to 10 on FMA-UE are more likely to experience or perceive a meaningful and clinically important improvement in their disability level than those who do not. The reference value can be used to develop goals and interpret progress in subacute poststroke patients.
authors: Department of Neurology, CSM Medical University, Lucknow, India.
authors: Kamal Narayan
authors: KN
authors: Arya
authors: Rajesh
authors: R
authors: Verma
authors: R K
authors: RK
authors: Garg
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000502:physiology; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012372:ROC Curve; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000502:physiology*