A Research On The Minimal Clinically Important Differences Of Chinese Version Of The Fugl-meyer Motor Scale

ObjectiveFirstly, the MCID(Minimal Clinically Important Differences) of Chinese version of the M-FMA(Fugl-Meyer Motor Scale) for evaluating the motor function of the stroke patients(upper extremity, lower extremity and total) will be established. Then, the intra-rater and inter-rater retest reliability of the Chinese version of this scale will be calculated and detected.MethodsIn order to determine the MCID, anchor-based and distribution-based methods were jointly applied. During the study with the anchor-based method, we chose 60 patients with stroke as our study objects and evaluated their rehabilitation efficacy(rehabilitation treatment lasts for 2 weeks) by using the M-FMA and the Likert-type scale. The study objects of the MCID group were the patients with ratings on the Likert-type scale(scored on +2 to +3), whose mean change scores on M-FMA and their 3 subscales served as the estimates of the MCID. During the study with the distribution-based method, we detected intra-rater and inter-rater reliability of M-FMA scale and 3 subscales before calculating the Standard error of measurement(SEM) according to the formula and denoted it as the MCID.ResultsDuring the study with the anchor-based method, patients with ratings on the Likert-type scale(scored on +2 to +3) were included into the MCID group, which means there were 12, 16 and 16 patients of the there scales(upper extremity, lower extremity and total scale) are included in the MCID group. According the above-mentioned study, the MCID values we calculated were 4.58, 3.31 and 6.0 respectively. During the study with the the distribution method, we finished the intra-rater and the inter-rater test-retest reliability of 56 patients. The intra-rater test-rarest reliability of the M-FMA(upper extremity, lower extremity and total scale) were 0.997, 0.989 and 0.997. With the help of the formula, the MCID(SEM values) were 0.84、0.86 and 1.2. The inter-rater test-rarest reliability of the M-FMA(upper extremity, lower extremity and total scale) were 0.993、0.952 and 0.990, and the MCID values were calculated as 1.26、1.85 and 2.22. After fully analyzing and calculating the statistics, the MCID of Chinese version of M-FMA(upper extremity, lower extremityand total scale) resulted in 4.58, 3.31 and 6.0.ConclusionIt is proved by our research that the Chinese version of the M-FMA also have an excellent intra-rater and inter-rater reliability. Meanwhile, we calculated the minimal clinically important differece at this scale. During the clinical and researching practice, if the mean change scores on the there scales(upper extremity, lower extremity and total M-FMA scale) within a stroke group have reached 4.58, 3.31 and 6.0 points, the motor function(upper extremity, lower extremity and total scale) of this group will be improved and measurement error will be overrun.