The minimal important change of the Fugl-Meyer Assessment- Lower Extremity motor scale in patients with acute stroke.
prospective_cohort · Level II
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- Record sourced from PubMed, PMID 41654004.
- Also identified by DOI 10.1016/j.apmr.2026.01.029.
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Abstract
To estimate anchor-based minimal important change (MIC) values for the Fugl-Meyer Assessment-Lower Extremity (FMA-LE) in patients with acute stroke from the perspectives of patients and physiotherapists using the receiver operating characteristic (MIC<sub>ROC</sub>) and bias-adjusted predictive modeling (MIC<sub>adjusted</sub>). Prospective cohort study. Stroke care unit at a single acute-care hospital. Adults with acute stroke analyzed (n=100); baseline assessment within 5 days of onset and follow-up at 2 weeks. Not applicable. The FMA-LE, Short Physical Performance Battery, and Functional Ambulation Category were assessed within 5 days and at 2 weeks after stroke onset. The anchors were the seven-point Global Rating of Change (GRC) scale for lower extremity (LE) motor function and walking among the patients and physiotherapists. Patient- and physiotherapist-rated GRC scores were assessed at 2 weeks. Patients' and physiotherapists' perspective GRC were divided into two groups based on meaningful improvement (GRC ≥ 6). Then, the MIC<sub>ROC</sub> and MIC<sub>adjusted</sub> of the FMA-LE were calculated. The MIC<sub>ROC</sub> values were 3.5 points (95% confidence interval: 0.5-7.5) for patient-rated GRC (LE motor function) and 3.5 (1.5-7.5) for patient-rated GRC (walking). The MIC<sub>ROC</sub> values were 1.5 points (0.5-6.5) for therapist-rated GRC (LE motor function) and 3.5 (0.5-7.5) for therapist-rated GRC (walking). The MIC<sub>adjusted</sub> values for patient-rated LE motor function and walking were both 4.3 points (3.7-4.9). The MIC<sub>adjusted</sub> values for physiotherapist-rated LE motor function and walking were 3.3 (2.4-4.1) to 3.8 points (3.0-4.4), respectively. The MIC<sub>adjusted</sub> values were more robust than the MIC<sub>ROC</sub> values. The MIC<sub>adjusted</sub> value from the physiotherapist's perspective was lower than that from the patient's perspective. These MIC values may be helpful for setting rehabilitation goals and evaluating interventions objectively, thereby providing important benchmarks for clinical decision-making in acute stroke rehabilitation.