Minimum Detectable Change and Minimal Clinically Important Difference for the Box and Block Test and Fugl-Meyer Assessment in Moderate to Severe Chronic Stroke.

The treatment comparison itself is not reported. This paper is about how the two tests behave and says nothing about whether the device or the robotic support helped. Everyone was a long way past their stroke (median 88.8 months), so these thresholds may not hold in the first weeks or months after stroke, when change is faster and more variable. Splitting 53 people into 5-point impairment bands left few people in each band, and the Fugl-Meyer smallest-detectable-change model only fitted moderately well (0.39). Only 44 of the 53 participants gave the self-rated change score, and that rating relies on memory and is open to bias. The authors stress that these thresholds are specific to this sample, its impairment levels and how the tests were carried out, and are not fixed constants.

The authors state that the investigators have no financial or nonfinancial disclosures to make in relation to this project.

Do not read the Box and Block Test figure of 0 blocks/min as proof that any change a patient notices is meaningless. That number came from a self-rating method in a group where 49% could not score at all, and once those participants were excluded the test no longer tracked how people said they felt.