Minimal Clinically Important Difference for Postural Assessment Scale for Stroke Patients (PASS) and Trunk Impairment Scale (TIS) in Persons With Stroke.

Abstract

To determine the minimum clinically important difference (MCID) values for the Postural Assessment Scale for Stroke Patients (PASS) and Trunk Impairment Scale (TIS) in persons with stroke. A pre-post interventional study using anchor-based methods. Inpatient rehabilitation unit. Sixty-five (N=65) persons with stroke. Twenty-session conventional physiotherapy program. The PASS, TIS, and Functional Independence Measure before and after the physiotherapy program. As the anchor measure, both patients and physiotherapists provided a Global Rating of Change scale score to reflect their perceived changes in postural and trunk control after the intervention. For the PASS, the MCID was 3.5, based on the patient as the anchor, with an area under the curve (AUC) of 0.89 (95% confidence interval [CI], 0.82-0.97). For the physiotherapist ratings, the MCID was 4.5, with an AUC of 0.94 (95% CI, 0.88-0.99). The MCID value was 8.5 for TIS, based on both the patient and physiotherapist as anchors, with AUCs of 0.97 (95% CI, 0.93-1.0) and 0.98 (95% CI, 0.95-1.0), respectively. There were strong correlations (ρ>0.70, P<.001) between the PASS, TIS, and global rating of change for both patients and physiotherapists, along with functional independence measure. The suggested MCID values for the PASS and TIS are 4.5 and 8.5, respectively, serving as benchmarks to evaluate the effectiveness of physiotherapy treatment in persons with stroke. These MCID values offer meaningful thresholds for identifying clinically important improvements in postural stability and trunk impairment, guiding therapeutic interventions and enhancing treatment evaluation in stroke rehabilitation.