學院

醫學院

系所

職能治療學系

題名

Responsiveness, minimal detectable change, and minimal clinically important difference of the Nottingham Extended Activities of Daily Living Scale in patients with improved performance after stroke rehabilitation

作者

Wu, C-Y., Chuang, L-L. Lin, K-C.*, Lee, S-D., & Hong, W-H.

期刊名稱

Archives of Physical Medicine and Rehabilitation (SCI 期刊)

發表日期

2011

著作性質

原著

語文

英文

關鍵字

Clinimetrics; Nottingham Extended Activities of Daily Living; Stroke rehabilitation.

摘要

Objectives: To determine the responsiveness, minimal detectable change (MDC), and minimal clinically important differences (MCID) of the Nottingham Extended Activities of Daily Living (NEADL) scale and to assess the percentages of patients' change scores exceeding the MDC and MCID after stroke rehabilitation. Design: Secondary analyses of patients who received stroke rehabilitation therapy. Setting: Medical centers. Participants: Patients with stroke (n = 78). Interventions: Secondary analyses of patients who received 1 of 4 rehabilitation interventions. Main Outcome Measures: Responsiveness (standardized response mean, SRM), MDC90, and MCID on the NEADL, and percentages of patients exceeding MDC90 and MCID. Results: The SRM of the total NEADL scale was 1.3. The MDC90 value for the total NEADL scale was 4.9, whereas the minima and maxima of the MCID for the total NEADL were 2.4 to 6.1 points, respectively. Percentages of patients exceeding the MDC90 and MCID of the total NEADL were 50.0%, 73.1%, and 32.1%, respectively. Conclusions: The NEADL is a responsive instrument relevant for measuring change in instrumental ADL after stroke rehabilitation. A patient's change score has to reach 4.9 points on the total to indicate a true change. The mean change score of a stroke group on the total NEADL scale should achieve 6.1 points to be regarded as clinically important changes. Our findings are based on patients with improved NEADL performance after they received specific interventions. Future research with larger sample sizes is warranted to validate these estimates.