Minimal Clinically Important Difference of Berg Balance Scale scores in people with acute stroke

Abstract

Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cutoff values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cutoff point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.

Technology-supported sitting balance therapy versus usual care in the chronic stage after stroke: A pilot randomized controlled trial

“…balance during 360°t urn or stepping in standing position. The clinical meaningful difference for the Berg balance score is 12.5 points (55). In this study, the median change score in the experimental group is about 4.5 points (in the control group zero).…”

Technology-supported sitting balance therapy versus usual care in the chronic stage after stroke: a pilot randomized controlled trial

“…The Berg Balance Scale (BBS) addresses many functions not directly targeted with T-Chair therapy, such as balance during 360° turns or alternate placing of foot on a step bench in in standing position. The clinically meaningful difference for the BBS is 12.5 points [ 54 ]. In this study, the median change score in the experimental group is about 4.5 points (in the control group zero).…”

Establishing the Minimal Clinically Important Differences for Sagittal Hip Range of Motion in Chronic Stroke Patients

“…Further research is needed with regard to the Patient Reported Outcome Measures, one of these being the Global Rating of Change. This tool enables measurement of the intervention outcomes and may be helpful in determining the amount of the minimum change expected by the patients, which is of key importance in patient-centered medical services ( 53 ). Importantly, in the current study the anchor-based estimate of the MCID for hip sagittal ROM assumes a higher value than the distribution-based estimate.…”

“…In addition to simple estimation of difference, the "important change" construct assumes that a change has taken place and, according to the patient, clinician, or investigator, it is important (33)(34)(35). We decided to divide the participants into groups based on their selfperceived change in hip ROM because this is an external criterion commonly used by researchers (32,34,36,40,(46)(47)(48)(49)(50)(51)(52)(53)(54), also in the case of patients at various stages and with moderate to severe hemiparesis after stroke (32,(50)(51)(52)(53)(54). However, stroke survivors are not always able to provide reliable information because of their sensory and/or proprioception impairments.…”