Chen Lin1, Yurany A Arevalo1, Richard L Harvey2, Shyam Prabhakaran3, Kimberly D Martin4. 1. Departments of Neurology, The University of Alabama at Birmingham, Birmingham, AL, USA. 2. Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA. 3. Department of Neurology, The University of Chicago, Chicago, IL, USA. 4. Departments of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
INTRODUCTION: The Motricity Index (MI) can predict motor function after rehabilitation, but its minimal clinically important difference (MCID) has not been established. The primary study aim was to estimate the MCID value of the MI arm score. METHODS: Between 2017 and 2018, 173 participants hospitalized with confirmed ischemic stroke were recruited into an observational rehabilitation study. Participants with motor weakness as measured by the Fugl-Meyer upper-extremity (FM-UE) and MI with complete baseline and follow-up assessments at 3 months were included in this analysis. The longitudinal recovery of the MI arm score was anchored to having a poor outcome based on the FM-UE recovery (<9) longitudinally. Results reported include the area-under-curve (AUC), along with sensitivity, specificity, and optimal cut-points based on maximizing the Youden statistic. RESULTS: Sixty-nine patients (median [IQR] age 70 [18] years; 48% male; 54% white) were included in the final analysis. Mean ± standard deviation outcome scores at 3-months were: MI arm: 83.19 ± 22.80; FM-UE: 53.04 ± 17.26. For the primary results, the MI arm score optimal MCID cutoff for observed recovery was 13 points with a sensitivity of 80% (95% Confidence Interval (CI)(67.6%, 92.4%)) and a specificity of 69.0% (95% CI (52.1, 85.8%)), and the AUC was 0.8082 (0.7007, 0.9157). CONCLUSIONS: This was the first study to report the MCID of the MI arm score, as anchored to the FM-UE recovery between acute evaluation and 3-months. The estimated optimal MCID of improvement in the MI arm score was 13 points.
INTRODUCTION: The Motricity Index (MI) can predict motor function after rehabilitation, but its minimal clinically important difference (MCID) has not been established. The primary study aim was to estimate the MCID value of the MI arm score. METHODS: Between 2017 and 2018, 173 participants hospitalized with confirmed ischemic stroke were recruited into an observational rehabilitation study. Participants with motor weakness as measured by the Fugl-Meyer upper-extremity (FM-UE) and MI with complete baseline and follow-up assessments at 3 months were included in this analysis. The longitudinal recovery of the MI arm score was anchored to having a poor outcome based on the FM-UE recovery (<9) longitudinally. Results reported include the area-under-curve (AUC), along with sensitivity, specificity, and optimal cut-points based on maximizing the Youden statistic. RESULTS: Sixty-nine patients (median [IQR] age 70 [18] years; 48% male; 54% white) were included in the final analysis. Mean ± standard deviation outcome scores at 3-months were: MI arm: 83.19 ± 22.80; FM-UE: 53.04 ± 17.26. For the primary results, the MI arm score optimal MCID cutoff for observed recovery was 13 points with a sensitivity of 80% (95% Confidence Interval (CI)(67.6%, 92.4%)) and a specificity of 69.0% (95% CI (52.1, 85.8%)), and the AUC was 0.8082 (0.7007, 0.9157). CONCLUSIONS: This was the first study to report the MCID of the MI arm score, as anchored to the FM-UE recovery between acute evaluation and 3-months. The estimated optimal MCID of improvement in the MI arm score was 13 points.
Authors: Shyam Prabhakaran; Eric Zarahn; Claire Riley; Allison Speizer; Ji Y Chong; Ronald M Lazar; Randolph S Marshall; John W Krakauer Journal: Neurorehabil Neural Repair Date: 2007-08-08 Impact factor: 3.919
Authors: Chen Lin; Jungwha Lee; Christopher P Hurt; Ronald M Lazar; Yurany A Arevalo; Shyam Prabhakaran; Richard L Harvey Journal: PM R Date: 2020-08-20 Impact factor: 2.298
Authors: Catherine E Lang; Marghuretta D Bland; Ryan R Bailey; Sydney Y Schaefer; Rebecca L Birkenmeier Journal: J Hand Ther Date: 2012-09-10 Impact factor: 1.908