The minimal clinically important difference of the Participation Measurement Scale in chronic stroke.
Oyéné Kossi, Soraia M Silva, Francesco Lena and 4 others
PMID 39968028WHAT IT FOUND
A change of 1.98 logits on the PM-Scale may mark important participation improvement in chronic stroke.
It was estimated from 46 people using the ACTIVLIM-Stroke anchor.
Key findings
01The estimated minimal clinically important difference for the PM-Scale was 1.98 logits, using the ACTIVLIM-Stroke scale as the anchor.
02Among 46 people with chronic stroke, PM-Scale change scores correlated with the ACTIVLIM-Stroke measure (r = 0.53), but not with the modified Rankin Scale or HADS depression scores.
03Across the 46 participants, PM-Scale measures changed from 0.61 logits at enrolment to 2.49 logits immediately post-intervention, with a reported change of 1.76 logits.
STILL TO COME
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What it does not show
The sample was small: 46 people with chronic stroke, and the authors state that this may limit generalisability. The estimate applies only to chronic stroke; the paper says it is unknown whether it applies to acute or subacute stroke. Only the ACTIVLIM-Stroke anchor was used for the MCID; the modified Rankin Scale and HADS depression subscale did not correlate significantly with PM-Scale change. Participants had to be able to walk 10 m with or without an assistive device and were excluded for major cognitive impairment, so the result may not apply to more severely affected stroke survivors. The paper notes that MCID values are context-specific and depend on disease severity, outcome, treatment regimen and culture.
Declared interests
The paper states that this research received no specific grant from any public, commercial or not-for-profit sector.
The easy way to misread this
Do not treat 1.98 logits as proof that a treatment works or as a universal threshold for all stroke survivors. It was estimated from 46 people with chronic stroke who could walk 10 m, using only the ACTIVLIM-Stroke anchor, and the paper says it applies only to the chronic stage.