Verification of the minimal clinically important difference of the Capabilities of Upper Extremity Test in patients with subacute spinal cord injury

J Spinal Cord Med. 2023 Nov 6:1-8. doi: 10.1080/10790268.2023.2273586. Online ahead of print.

Abstract

Context: The number of patients with cervical spinal cord injury (CSCI) is increasing, and the Capabilities of Upper Extremity Test (CUE-T) is recommended for introduction in clinical trials. We calculated the minimal clinically important difference (MCID) of the CUE-T using an adjustment model with an interval of 1 month.

Design: This was a prospective study.

Setting: This study was conducted with participants from the Chiba Rehabilitation Center in Japan.

Participants: The participants were patients with subacute CSCI.

Interventions: The CUE-T and spinal cord independence measure (SCIM) III were performed twice within an interval of 1 month.

Outcome measures: The MCID was calculated using an adjustment model based on logistic regression analysis. The participants were classified into an improvement group and a non-improvement group based on the amount of change in the two evaluations using the 10-point SCIM III MCID as an anchor.

Results: There were 52 participants (56.8 ± 13.5 years old, 45 men/7 women) with complete or incomplete CSCI: 18 in the improvement group and 34 in the non-improvement group. A significant regression equation was obtained when calculating the MCID, and the total, hand, and side scores were 7.7, 2.0, and 3.7 points, respectively.

Conclusion: The calculated MCID of the CUE-T in this study was 7.7 points. The results of this study provide useful criteria for implementation in clinical trials. Future studies should use patient-reported outcomes, a more recommended anchor, and calculate the MCID using methods such as the patient's condition.

Keywords: Minimal clinically important difference; Outcome measure; Rehabilitation; Spinal cord injuries; Upper limb function.