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.
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 strokepatients 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.