Friday, August 2, 2024

Minimal and robust clinically important differences for patient-reported outcome measures of fatigue in chronic stroke survivors after fatigue rehabilitation

I have never seen anything on fatigue rehab other than the useless; 'management' of it! So ask your competent? doctor to find this fatigue rehab.

Minimal and robust clinically important differences for patient-reported outcome measures of fatigue in chronic stroke survivors after fatigue rehabilitation

Received 25 Oct 2023, Accepted 13 Jul 2024, Published online: 28 Jul 2024
 

 

Abstract

Purpose

The minimal and robust clinically important difference (MCID and/or RCID) are essential in assessing the clinical significance of multidimensional fatigue inventory-20 and checklist of individual strength-fatigue subscale questionnaires changes scores. This is the first study to determine the MCID and RCID of these questionnaires in chronic stroke survivors.

Materials and methods

A total of 125 participants in an observational cohort study completed MFI-20 and CIS-fs before and after receiving multidisciplinary rehabilitation (cognitive behavioral therapy, graded exercise and adaptive pacing therapy). Anchor-based MCIDs and RCIDs were calculated using the mean change, the mean difference and the receiver operating characteristics methods. To evaluate the accordance between of distribution-based MCIDs (1 SD, ½ SD, SEM, 1.96 SEM and MDC values) with anchored values, the accuracy, sensitivity, specificity and Youden’s index were calculated.

Results

The anchored MCIDs were between −5 to −7.33 for MFI-20 and −4.87 to −5.40 for CIS-fs. The anchored RCIDs ranged from −5 to −13.88 and −6 to −9.88 for MFI-20 and CIS-fs, respectively. The values of ½ SD and SEM for CIS-fs were consistent with anchored RCIDs.

Conclusions

The estimated MCIDs and RCIDs of MFI-20 and CIS-fs can help researchers and clinicians interpret their chronic stroke patient data.

IMPLICATIONS FOR REHABILITATION

  • The Multidimensional Fatigue Inventory-20 (MFI-20) And Checklist Individual Strength-20 (CIS-20) Measures Are Two Important And Valid Instruments For Measuring Fatigue In Patients With Chronic Stroke.

  • The Identified Minimal Clinically Important Differences (MCID) And Robust Clinically Important Difference In The Current Study Can Assist Clinicians In The Clinical Interpretation Of Fatigue Changes Observed In MFI-20 And CIS-20 Scores.

  • The MCID Obtained In This Study Can Be Useful In Determining The Proportion Of Patients Who Benefit From Fatigue Treatment In Stroke Rehabilitation.

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