Minimal clinically important difference for change in comfortable gait speed of adults with pathology: a systematic review

2014 ◽  
Vol 20 (4) ◽  
pp. 295-300 ◽  
Author(s):  
Richard W. Bohannon ◽  
Susan S. Glenney
Keyword(s):  
Systematic Review ◽  
Gait Speed ◽  
Minimal Clinically Important Difference ◽  
Clinically Important Difference

Clinical Outcomes of Meniscal Allograft Transplantation With Respect to the Minimal Clinically Important Difference

2021 ◽  
pp. 036354652110361
Author(s):  
Lisa Su ◽  
Ignacio Garcia-Mansilla ◽  
Benjamin Kelley ◽  
Armin Arshi ◽  
Peter Fabricant ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Minimal Clinically Important Difference ◽  
Meta Analysis ◽  
Weighted Mean ◽  
Meniscal Allograft Transplantation ◽  
Clinically Important Difference ◽  
Meniscal Allograft ◽  
Patient Reported ◽  
Fresh Frozen

Background: Arthroscopic-assisted meniscal allograft transplantation (MAT) has become a viable and effective treatment option for young active patients with postmeniscectomy pain. The minimal clinically important difference (MCID) of patient-reported outcome measures (PROMs) is imperative to evaluate the clinical significance of surgical interventions and inform clinical practice guidelines in orthopaedic surgery. Purpose: To perform a systematic review of clinical outcome studies of patients undergoing MAT and compare postoperative improvement with established MCID thresholds. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review was performed using the PubMed, Web of Science, and Cochrane Library databases. A meta-analysis was performed using data obtained from studies reporting patient-reported outcomes. Subgroup analysis was performed on patients undergoing isolated lateral MAT using fresh-frozen grafts. Weighted mean postoperative improvements in the International Knee Documentation Committee (IKDC), Lysholm, and visual analog scale for pain (VAS pain) were calculated and compared with MCID values to determine if they met the MCID threshold. Results: A total of 35 studies were identified, including 1658 unique patients. Weighted mean postoperative score improvements exceeded MCID thresholds for the VAS pain, IKDC, and Lysholm. Subgroup analysis of patients undergoing isolated lateral fresh-frozen MAT demonstrated postoperative improvements exceeding the MCID for the Lysholm and VAS pain. Conclusion: Evaluating postoperative PROMs with respect to the MCID is crucial to evaluate the effect of MAT on functional improvement. The results of the present meta-analysis suggest that postoperative improvements after MAT are clinically meaningful as reflected by PROMs exceeding the MCID threshold for the IKDC, Lysholm, and VAS pain.

scholarly journals Articular Cartilage Repair of the Pediatric and Adolescent Knee with Regard to Minimal Clinically Important Difference: A Systematic Review

Cartilage ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Rosa S. Valtanen ◽  
Armin Arshi ◽  
Benjamin V. Kelley ◽  
Peter D. Fabricant ◽  
Kristofer J. Jones
Keyword(s):  
Systematic Review ◽  
Articular Cartilage ◽  
Clinical Outcomes ◽  
Cartilage Repair ◽  
Minimal Clinically Important Difference ◽  
Cochrane Library ◽  
Clinically Important Difference ◽  
Outcome Score ◽  
The Mean

Objective To perform a systematic review of clinical outcomes following microfracture (MFX), autologous chondrocyte implantation (ACI), osteochondral allograft transplantation (OCA), and osteochondral autograft transplantation system (OATS) to treat articular cartilage lesions in pediatric and adolescent patients. We sought to compare postoperative improvements for each cartilage repair method to minimal clinically important difference (MCID) thresholds. Design MEDLINE, Web of Science, Scopus, and Cochrane Library databases were searched for studies reporting MCID-validated outcome scores in a minimum of 5 patients ≤19 years treated for symptomatic knee chondral lesions with minimum 1-year follow-up. One-sample t tests were used to compare mean outcome score improvements to established MCID thresholds. Results Twelve studies reporting clinical outcomes on a total of 330 patients following cartilage repair were identified. The mean age of patients ranged from 13.7 to 16.7 years and the mean follow-up was 2.2 to 9.6 years. Six studies reported on ACI, 4 studies reported on MFX, 2 studies reported on OATS, and 1 study reported on OCA. ACI ( P < 0.001, P = 0.008) and OCA ( P < 0.001) showed significant improvement for International Knee Documentation Committee (IKDC) scores with regard to MCID while MFX ( P = 0.66) and OATS ( P = 0.11) did not. ACI ( P < 0.001) and OATS ( P = 0.010) both showed significant improvement above MCID thresholds for Lysholm scores. MFX ( P = 0.002) showed visual analog scale (VAS) pain score improvement above MCID threshold while ACI ( P = 0.037, P = 0.070) was equivocal. Conclusions Outcomes data on cartilage repair in the pediatric and adolescent knee are limited. This review demonstrates that all available procedures provide postoperative improvement above published MCID thresholds for at least one reported clinical pain or functional outcome score.

scholarly journals The 4-metre gait speed in COPD: responsiveness and minimal clinically important difference

2013 ◽  
Vol 43 (5) ◽  
pp. 1298-1305 ◽  
Author(s):  
S. S. C. Kon ◽  
J. L. Canavan ◽  
C. M. Nolan ◽  
A. L. Clark ◽  
S. E. Jones ◽  
...  
Keyword(s):  
Gait Speed ◽  
Minimal Clinically Important Difference ◽  
Clinically Important Difference

scholarly journals Meaningful Gait Speed Improvement During the First 60 Days Poststroke: Minimal Clinically Important Difference

2010 ◽  
Vol 90 (2) ◽  
pp. 196-208 ◽  
Author(s):  
Julie K. Tilson ◽  
Katherine J. Sullivan ◽  
Steven Y. Cen ◽  
Dorian K. Rose ◽  
Cherisha H. Koradia ◽  
...  
Keyword(s):  
Gait Speed ◽  
Minimal Clinically Important Difference ◽  
Reference Value ◽  
Minimal Amount ◽  
Meaningful Improvement ◽  
Clinically Important Difference ◽  
Subacute Stroke ◽  
Improved Function ◽  
Prospective Longitudinal ◽  
Disability Level

BackgroundWhen people with stroke recover gait speed, they report improved function and reduced disability. However, the minimal amount of change in gait speed that is clinically meaningful and associated with an important difference in function for people poststroke has not been determined.ObjectiveThe purpose of this study was to determine the minimal clinically important difference (MCID) for comfortable gait speed (CGS) associated with an improvement in the modified Rankin Scale (mRS) score for people between 20 to 60 days poststroke.DesignThis was a prospective, longitudinal, cohort study.MethodsThe participants in this study were 283 people with first-time stroke prospectively enrolled in the ongoing Locomotor Experience Applied Post Stroke (LEAPS) multi-site randomized clinical trial. Comfortable gait speed was measured and mRS scores were obtained at 20 and 60 days poststroke. Improvement of ≥1 on the mRS was used to detect meaningful change in disability level.ResultsMean (SD) CGS was 0.18 (0.16) m/s at 20 days and 0.39 (0.22) m/s at 60 days poststroke. Among all participants, 47.3% experienced an improvement in disability level ≥1. The MCID was estimated as an improvement in CGS of 0.16 m/s anchored to the mRS.LimitationsBecause the mRS is not a gait-specific measure of disability, the estimated MCID for CGS was only 73.9% sensitive and 57.0% specific for detecting improvement in mRS scores.ConclusionsWe estimate that the MCID for gait speed among patients with subacute stroke and severe gait speed impairments is 0.16 m/s. Patients with subacute stroke who increase gait speed ≥0.16 m/s are more likely to experience a meaningful improvement in disability level than those who do not. Clinicians can use this reference value to develop goals and interpret progress in patients with subacute stroke.

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