Minimal clinically important difference of the lower-extremity fugl–meyer assessment in chronic-stroke

Pandian, Shanta; Arya, Kapil; Kumar, Dharmendra

doi:10.1179/1945511915y.0000000003

Cited by 55 publications

(39 citation statements)

References 17 publications

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“…37 It is also greater than, or similar to, that reported in other treadmill training studies with and without BWS. Lower extremity impairment, as measured using the FM, also improved by >7 points and exceeded the threshold for a perceived meaningful recovery (6 points) by individuals with chronic stroke 38 and was greater than the 1.5-point improvement demonstrated in the only other BWS training study 34 reporting FM scores. Finally, the average improvement of 3.9 points in the motor domain of the FIM for our participants was also greater than the 1.7-point change seen in a previous BWS treadmill training study.…”

Section: Discussionmentioning

confidence: 70%

Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke

Gama

Celestino

Barela

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Section: Discussionmentioning

confidence: 70%

Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke

Gama

Celestino

Barela

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…The improvement of 10% is the minimum effect that has been previously considered to be of clinical significance [42] and the FMA and WMFT are highly recommended for measuring the outcomes of patients with stroke [46]. The reported minimal clinically important difference values for chronic patients were 6 for the lower-extremity FMA [47] and 1–1.2 for the WMFT functional score [48]. Therefore, our definition of improvement is beyond the result of chance or increasing familiarity with the test observed in chronic patients.…”

Section: Discussionmentioning

confidence: 99%

EEG-based motor network biomarkers for identifying target patients with stroke for upper limb rehabilitation and its construct validity

et al. 2017

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Rehabilitation is the main therapeutic approach for reducing poststroke functional deficits in the affected upper limb; however, significant between-patient variability in rehabilitation efficacy indicates the need to target patients who are likely to have clinically significant improvement after treatment. Many studies have determined robust predictors of recovery and treatment gains and yielded many great results using linear approachs. Evidence has emerged that the nonlinearity is a crucial aspect to study the inter-areal communication in human brains and abnormality of oscillatory activities in the motor system is linked to the pathological states. In this study, we hypothesized that combinations of linear and nonlinear (cross-frequency) network connectivity parameters are favourable biomarkers for stratifying patients for upper limb rehabilitation with increased accuracy. We identified the biomarkers by using 37 prerehabilitation electroencephalogram (EEG) datasets during a movement task through effective connectivity and logistic regression analyses. The predictive power of these biomarkers was then tested by using 16 independent datasets (i.e. construct validation). In addition, 14 right handed healthy subjects were also enrolled for comparisons. The result shows that the beta plus gamma or theta network features provided the best classification accuracy of 92%. The predictive value and the sensitivity of these biomarkers were 81.3% and 90.9%, respectively. Subcortical lesion, the time poststroke and initial Wolf Motor Function Test (WMFT) score were identified as the most significant clinical variables affecting the classification accuracy of this predictive model. Moreover, 12 of 14 normal controls were classified as having favourable recovery. In conclusion, EEG-based linear and nonlinear motor network biomarkers are robust and can help clinical decision making.

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“…The averaged value of 3 trials were used for data analysis. The lower extremity motor control was evaluated by FMA scale which has been reported with good reliability for stroke patients 46,47 . The total score of lower extremity part is 34, and higher score indicates better control of lower extremity.…”

Section: Outcome Measuresmentioning

confidence: 99%

The effects of Ai Chi for balance in individuals with chronic stroke: a randomized controlled trial

Ku¹,

Chen

Yang³

et al. 2020

Sci Rep

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This study investigated the effectiveness of Ai Chi compared to conventional water-based exercise on balance performance in individuals with chronic stroke. A total of 20 individuals with chronic stroke were randomly allocated to receive either Ai Chi or conventional water-based exercise for 60 min/time, 3 times/week, and a total of 6 weeks. Balance performance assessed by limit of stability (LOS) test and Berg balance scale (BBS). Fugl-Meyer assessment (FMA) and gait performance were documented for lower extremity movement control and walking ability, respectively. Excursion and movement velocity in LOS test was significantly increased in anteroposterior axis after receiving Ai Chi (p = 0.005 for excursion, p = 0.013 for velocity) but not conventional water-based exercise. In particular, the improvement of endpoint excursion in the Ai Chi group has significant inter-group difference (p = 0.001). Both groups showed significant improvement in BBS and FMA yet the Ai Chi group demonstrated significantly better results than control group (p = 0.025). Ai Chi is feasible for balance training in stroke, and is able to improve weight shifting in anteroposterior axis, functional balance, and lower extremity control as compared to conventional water-based exercise.Stroke is a cerebral vascular disease caused by the interruption of the blood supply to the brain, cutting off the supply of oxygen and nutrients 1 . Damage to the brain tissue leads to sensory, motor, cognitive, and emotional deficits. With impaired motor and sensory functions, stroke patients suffer from deficits in balance control which plays crucial role in ambulatory function and thus as an important clinical indicator 2-5 . Balance is defined as the ability to maintain center of mass (COM) within the stability limits, the boundaries of the base of support (BOS) 6 . Balance control can be quantified by limit of stability (LOS) test, expressed by movement velocity, displacement excursion, and directional control 7,8 . Individuals with stroke usually show decline in the abovementioned balance performance 9-12 . Bohannon 13 noted the correlation between static standing ability and independent mobility in stroke patients (r = 0.62). Lee et al. 14 found that walking velocity is associated with maximal displacement excursion in LOS test (r = 0.68, p < 0.01) and Berg balance scale (r = 0.66, p < 0.01) in patients with stroke. In addition, the balance-related fall risks should also be addressed in people with chronic stroke 15,16 . Therefore, it is crucial to improve balance control in order to improve the balance-related activities for individuals with stroke.Several elements, such as strengthening, postural control, weight shifting, and agility exercise, are necessary to be incorporated during balance training 17 . It has also been noted that increased somatosensory inputs and visual deprivation might exert positive effects on top of balance training, as well as enriched environment 4,5,18,19 . Water-based exercise, by utilizing the properties of water, including ...

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Minimal clinically important difference of the lower-extremity fugl–meyer assessment in chronic-stroke

Cited by 55 publications

References 17 publications

Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke

Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke

EEG-based motor network biomarkers for identifying target patients with stroke for upper limb rehabilitation and its construct validity

The effects of Ai Chi for balance in individuals with chronic stroke: a randomized controlled trial

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