Deans' stroke musings: Responsiveness, Minimal Clinically Important Difference, and Validity of the MoCA in Stroke Rehabilitation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, April 20, 2019

Responsiveness, Minimal Clinically Important Difference, and Validity of the MoCA in Stroke Rehabilitation

I got absolutely nothing useful out of this. But then I'm stroke-addled and can't understand a damn thing about stroke.

Responsiveness, Minimal Clinically Important Difference, and Validity of the MoCA in Stroke Rehabilitation

Ching-Yi Wu ,1,2 Shuan-Ju Hung,3 Keh-chung Lin ,3,4 Kai-Hua Chen ,5,6 Poyu Chen,1 and Pei-Kwei Tsay7 1Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan 2Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan 3School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan 4Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan 5College of Medicine, Chang Gung University, Taoyuan, Taiwan 6Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan 7School of Nursing, Chang Gung University, Taoyuan, Taiwan
Correspondence should be addressed to Keh-chung Lin; kehchunglin@ntu.edu.tw Received 17 September 2018; Accepted 13 March 2019; Published 14 April 2019
Academic Editor: Lynette Mackenzie
Copyright © 2019 Ching-Yi Wu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. Persons with stroke frequently suﬀer from cognitive impairment. The Montreal Cognitive Assessment (MoCA), a recently developed screening tool, is sensitive to poststroke cognitive deﬁcits. The present study assessed its psychometric and clinimetric properties (i.e., responsiveness, minimal clinically important diﬀerence (MCID), and criterion validity) in stroke survivors receiving rehabilitative therapy.
Method. The MoCA and the Stroke Impact Scale (SIS) were administered to 65 stroke survivors before and after 4 to 5 weeks of therapy. The eﬀect size and standardized response mean (SRM) were calculated for responsiveness. Anchor- and distribution-based methods were used to estimate the MCID. Criterion validity was measured with the Spearman correlation coeﬃcient.
Results. The responsiveness of the MoCA was moderate (SRM=067). Participants exceeding the MCID according to the anchor- and distribution-based approaches were 33 (50.77%) and 20 (30.77%), respectively. Fair to good concurrent validity was reported between the MoCA and the SIS communication subscale. The MoCA had satisfactory predictive validity with the SIS communication and memory subscales.
Conclusion. This study may support the responsiveness, MCID, and criterion validity of the MoCA in stroke populations. Future studies with larger sample sizes are needed to validate the current ﬁndings.