脑卒中恢复期患者Fugl-Meyer下肢运动评估的最小临床重要性差值分析  

作　　者：王石艳 杨杭 高真真 周晔 毛雅君 

机构地区：[1]浙江中医药大学附属第一医院(浙江省中医院),310006

出　　处：《浙江临床医学》2023年第2期207-209,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省卫生健康科技计划(2022KY922);国家中医药管理局中医药康复服务能力提升项目(20221603)。

摘　　要：目的 建立脑卒中恢复期患者Fugl-Meyer(FM)下肢运动功能评定的最小临床重要性差值(MCID).方法 使用校标法和基于受试者操作特征曲线(ROC曲线)的可视化方法确定FM下肢运动功能评定量表的MCID.结果 使用校标法计算Fugl-Meyer量表下肢运动(FMA-LE)得分的MCID为5.9,而ROC曲线中使用FAC(敏感度90%,特异度70%)发现FMA-LE的MCID得分为6(AUC=0.743,P=0.015),使用李克特分级(敏感度93%,特异度67%)发现FMA-LE的估计MCID得分为5(AUC=0.781,P=0.008).结论 在脑卒中恢复期患者中,FM下肢运动功能评定量表的MCID为6分,在FM下肢运动功能评定量表达到6分变化的患者将感知到下肢功能有意义的恢复.Objective To establish the minimum clinically important diference(MCID)of the Fugl-Meyer assessment:Lower extremity(FMA-LE)in chronic poststroke hemiparetic(<6 months)stroke subjects.Methods Both calibration method and distribution method were used to determine the MCID of the FMA-LE.Results The MCID of the FMA-LE using the calibration method was 5.9,while the operating characteristic curve(ROC)curve using FAC(sensitivity 90%,specificity 70%)found that the MCID score of the FMA-LE was 6(AUC=0.743,P=0.015).Using Likert scale(sensitivity 93%,specificity 67%),the estimated MCID score for FMA-LE was found to be 5(AUC=0.781,P=0.008).Conclusion In chronic poststroke hemiparetic subjects,the computed MCID of FMA-LE is a score of 6.The subjects who achieve a change in a score of6 on FMA-LE will perceive a meaningful recovery of lower extremity function than those who do not.The reference value may be utilized in stroke rehabilitation.

关 键 词：最小临床重要性差值 脑卒 Fugl-Meyer下肢运动功能评定量表 

分 类 号：R74[医药卫生—神经病学与精神病学]