Wilkinson et al. MCID in physical function following exercise in CKD_Am J Phys Rehab.pdf (236.84 kB)
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The ‘minimum clinically important difference’ in frequently reported objective physical function tests following a 12-week renal rehabilitation exercise intervention in non-dialysis chronic kidney disease

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posted on 16.05.2019, 10:08 by Thomas J. Wilkinson, Emma L. Watson, Soteris Xenophontos, Douglas W. Gould, Alice C. Smith
Objective Chronic kidney disease (CKD) patients are characterized by impaired physical function. The goal of exercise-based interventions is an improvement in functional performance. However, improvements are often determined by ‘statistically significant’ changes. We investigated the ‘minimum clinically important difference’ (MCID), ‘the smallest change that is important to the patient’, for commonly reported physical function tests. Design Non-dialysis CKD patients completed 12-weeks of a combined aerobic (plus resistance training). The incremental shuttle walking test (ISWT), sit-to-stand-5 (STS-5) and 60 (STS-60), estimated 1 repetition maximum (e1RM) for the knee extensors, and VO2peak were assessed. After the intervention, patients rated their perceived change in health. Both anchor- and distribution-based MCID approaches were calculated. Results The MCID was calculated as follows: ISWT, +45m; STS-5, -4.2 seconds; VO2peak, +1.5 ml/kg/min. Due to comparable increases in ‘anchor’ groups, no MCID was estimated for the STS-60 or e1RM. Conclusion We have established the MCID in CKD for common tests of physical function. These values represent the minimum change required for patients to perceive noticeable and beneficial change to their health. These scores will help interpret changes following exercise interventions where these tests are employed. These MCIDs can be used to power future studies to detect clinically important changes.

Funding

This work was gratefully part-funded by the Stoneygate Trust. The research was supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC).

History

Citation

American Journal of Physical Medicine and Rehabilitation, 2018

Author affiliation

/Organisation

Version

AM (Accepted Manuscript)

Published in

American Journal of Physical Medicine and Rehabilitation

Publisher

Lippincott, Williams & Wilkins for Asociación Médica Latinoamericana de Rehabilitación (AMLAR), Association of Academic Physiatrists (AAP)

issn

0894-9115

Acceptance date

10/10/2018

Copyright date

2018

Available date

22/10/2019

Publisher version

https://journals.lww.com/ajpmr/Abstract/publishahead/The__minimum_clinically_important_difference__in.98381.aspx

Notes

The file associated with this record is under embargo until 12 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.

Language

en

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