Minimum Clinically Important Difference of Gross Motor Function and Gait Endurance in Children with Motor Impairment: A Comparison of Distribution-Based Approaches
| Autor: | Elena Beretta, Sandra Strazzer, Fabio Storm, Emilia Biffi, Flaminia Frascarelli, A. Colazza, Maurizio Petrarca, Daniele Panzeri, L. Piccinini, Cristina Maghini, Gianluigi Reni, Claudio Corbetta, Giampietro Cordone, Enrico Castelli, Roberta Morganti |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
030506 rehabilitation medicine.medical_specialty Adolescent Article Subject Motor Disorders Population Differential Threshold Walk Test General Biochemistry Genetics and Molecular Biology Cerebral palsy 03 medical and health sciences 0302 clinical medicine Gait training Interquartile range Humans Medicine Child education Gait Acquired brain injury Retrospective Studies education.field_of_study General Immunology and Microbiology business.industry Cerebral Palsy Minimal clinically important difference Retrospective cohort study Robotics General Medicine medicine.disease humanities Exercise Therapy Treatment Outcome Motor Skills Brain Injuries Cohort Physical therapy Female 0305 other medical science business 030217 neurology & neurosurgery Research Article |
| Zdroj: | BioMed Research International BioMed Research International, Vol 2020 (2020) |
| ISSN: | 2314-6133 |
| DOI: | 10.1155/2020/2794036 |
| Popis: | Objective. The minimum clinically important difference (MCID) is a standard way of measuring clinical relevance. The objective of this work was to establish the MCID for the 6-minute walking test (6minWT) and the Gross Motor Function Measure (GMFM-88) in pediatric gait disorders. Methods. A cohort, pretest-posttest study was conducted in a hospitalized care setting. A total of 182 patients with acquired brain injury (ABI) or cerebral palsy (CP) performed 20 robot-assisted gait training sessions complemented with 20 sessions of physical therapy over 4 weeks. Separate MCIDs were calculated using 5 distribution-based approaches, complemented with an anonymized survey completed by clinical professionals. Results. The MCID range for the 6minWT was 20-38 m in the ABI cohort, with subgroup ranges of 20-36 m for GMFCS I-II, 23-46 m for GMFCS III, and 24-46 m for GMFCS IV. MCIDs for the CP population were 6-23 m, with subgroup ranges of 4-28 m for GMFCS I-II, 9-19 m for GMFCS III, and 10-27 m for GMFCS IV. For GMFM-88 total score, MCID values were 1.1%-5.3% for the ABI cohort and 0.1%-3.0% for the CP population. For dimension “D” of the GMFM, MCID ranges were 2.3%-6.5% and 0.8%-5.2% for ABI and CP populations, respectively. For dimension “E,” MCID ranges were 2.8%-6.5% and 0.3%-4.9% for ABI and CP cohorts, respectively. The survey showed a large interquartile range, but the results well mimicked the distribution-based methods. Conclusions. This study identified for the first time MCID ranges for 6minWT and GMFM-88 in pediatric patients with neurological impairments, offering useful insights for clinicians to evaluate the impact of treatments. Distribution-based methods should be used with caution: methods based on pre-post correlation may underestimate MCID when applied to patients with small improvements over the treatment period. Our results should be complemented with estimates obtained using consensus- and anchor-based approaches. |
| Databáze: | OpenAIRE |
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