The minimal clinically important difference of the motricity index score.
Chen Lin, Yurany A Arevalo, Richard L Harvey and 2 others
PMID 35094664WHAT IT FOUND
In 69 patients assessed early after stroke, a 13-point rise on the 0-99 Motricity Index arm score was the cutoff for meaningful recovery compared with another upper-limb test.
Key findings
01For the Motricity Index arm score, which ranges from 0-99, a 13-point increase was the optimal cutoff for detecting poor Fugl-Meyer Upper Extremity recovery of less than 9 points on the 0-66 scale, with 80% sensitivity and 69.0% specificity.
02Only 69 of 173 enrolled patients were analysed, because 97 had missing assessment data, 6 had no motor weakness, and 1 had cognitive impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 69 of 173 enrolled patients were analysed; 97 had missing assessment data, 6 had no motor weakness, and 1 had cognitive impairment. The study was done in one urban academic referral hospital, so the cutoff may not generalize to other settings. Follow-up was at 3 months, and the authors note MCID estimates change with time after stroke; this estimate is for patients assessed early after stroke. The MI arm cutoff was anchored to FM-UE poor recovery of less than 9 points, so it is not a direct measure of function or independence. P-values are unadjusted for multiple comparisons. Whether acute stroke interventions such as tissue plasminogen activator or endovascular therapy were provided was not part of selection criteria, so those treatments may have affected recovery.
Declared interests
The supplied publication types list research support from N.I.H., Extramural and U.S. Gov't, Non-P.H.S. sources. No author conflict-of-interest statement or sponsor role is provided in the supplied text.
The easy way to misread this
Do not use the 13-point MI arm increase as a universal treatment target. It was estimated from 69 analysed patients assessed within two weeks of stroke and at 3 months, and the authors say MCID values depend on time after stroke.