Abstract
Objective: To determine the sensitivity to change and minimal clinically important difference (MCID) for the self-administered Locomotor Capabilities Index-5 (LCI-5) in people with lower limb amputation undergoing prosthetic training. Design: Prospective single-group observational study. Methods: The LCI-5 was administered to 110 patients (69 males [63%]; median [interquartile range] age, 60 [48–69] years) before and after prosthetic training. The external anchor administered after the program was a 7-point Global Rating of Change Scale (GRCS) designed to quantify the effect (improvement or deterioration) of the intervention. Results: Test–retest reliability of the LCI-5 (n = 30) was high (intraclass correlation coefficient [ICC 2,1 ] = 0.92). The minimum detectable change at the 95% confidence level was 5.66 points. After triangulating these results with those of the mean-change approach and receiver operating characteristic (ROC) curve analysis (area under the ROC curve ≥ 0.90), based on a different GRCS score splitting, we identified 2 cutoffs for the LCI-5: a change of 7 points, indicating the MCID, and 12 points, indicating “large improvement” in locomotor capabilities (12.5% and 21.4% of the maximum possible score, respectively). Conclusions: The LCI-5 showed a high ability to detect change over time (responsiveness). The 2 proposed values (MCID of 7 points and large improvement of 12 points), based on a mix of distribution- and anchor-based approaches, represent cutoffs that can accurately identify 2 different levels of true change (as perceived by the patient) in locomotor capability after prosthetic training.
| Original language | English |
|---|---|
| Journal | Annals of Physical and Rehabilitation Medicine |
| DOIs | |
| Publication status | Published - Jan 1 2019 |
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Keywords
- Leg prosthesis
- Lower-limb amputation
- Outcome assessment
- Prosthetic training
- Psychometrics
- Rehabilitation
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Rehabilitation
Cite this
Sensitivity to change and minimal clinically important difference of the Locomotor Capabilities Index-5 in people with lower limb amputation undergoing prosthetic training. / Franchignoni, Franco; Traballesi, Marco; Monticone, Marco; Giordano, Andrea; Brunelli, Stefano; Ferriero, Giorgio.
In: Annals of Physical and Rehabilitation Medicine, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Sensitivity to change and minimal clinically important difference of the Locomotor Capabilities Index-5 in people with lower limb amputation undergoing prosthetic training
AU - Franchignoni, Franco
AU - Traballesi, Marco
AU - Monticone, Marco
AU - Giordano, Andrea
AU - Brunelli, Stefano
AU - Ferriero, Giorgio
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective: To determine the sensitivity to change and minimal clinically important difference (MCID) for the self-administered Locomotor Capabilities Index-5 (LCI-5) in people with lower limb amputation undergoing prosthetic training. Design: Prospective single-group observational study. Methods: The LCI-5 was administered to 110 patients (69 males [63%]; median [interquartile range] age, 60 [48–69] years) before and after prosthetic training. The external anchor administered after the program was a 7-point Global Rating of Change Scale (GRCS) designed to quantify the effect (improvement or deterioration) of the intervention. Results: Test–retest reliability of the LCI-5 (n = 30) was high (intraclass correlation coefficient [ICC 2,1 ] = 0.92). The minimum detectable change at the 95% confidence level was 5.66 points. After triangulating these results with those of the mean-change approach and receiver operating characteristic (ROC) curve analysis (area under the ROC curve ≥ 0.90), based on a different GRCS score splitting, we identified 2 cutoffs for the LCI-5: a change of 7 points, indicating the MCID, and 12 points, indicating “large improvement” in locomotor capabilities (12.5% and 21.4% of the maximum possible score, respectively). Conclusions: The LCI-5 showed a high ability to detect change over time (responsiveness). The 2 proposed values (MCID of 7 points and large improvement of 12 points), based on a mix of distribution- and anchor-based approaches, represent cutoffs that can accurately identify 2 different levels of true change (as perceived by the patient) in locomotor capability after prosthetic training.
AB - Objective: To determine the sensitivity to change and minimal clinically important difference (MCID) for the self-administered Locomotor Capabilities Index-5 (LCI-5) in people with lower limb amputation undergoing prosthetic training. Design: Prospective single-group observational study. Methods: The LCI-5 was administered to 110 patients (69 males [63%]; median [interquartile range] age, 60 [48–69] years) before and after prosthetic training. The external anchor administered after the program was a 7-point Global Rating of Change Scale (GRCS) designed to quantify the effect (improvement or deterioration) of the intervention. Results: Test–retest reliability of the LCI-5 (n = 30) was high (intraclass correlation coefficient [ICC 2,1 ] = 0.92). The minimum detectable change at the 95% confidence level was 5.66 points. After triangulating these results with those of the mean-change approach and receiver operating characteristic (ROC) curve analysis (area under the ROC curve ≥ 0.90), based on a different GRCS score splitting, we identified 2 cutoffs for the LCI-5: a change of 7 points, indicating the MCID, and 12 points, indicating “large improvement” in locomotor capabilities (12.5% and 21.4% of the maximum possible score, respectively). Conclusions: The LCI-5 showed a high ability to detect change over time (responsiveness). The 2 proposed values (MCID of 7 points and large improvement of 12 points), based on a mix of distribution- and anchor-based approaches, represent cutoffs that can accurately identify 2 different levels of true change (as perceived by the patient) in locomotor capability after prosthetic training.
KW - Leg prosthesis
KW - Lower-limb amputation
KW - Outcome assessment
KW - Prosthetic training
KW - Psychometrics
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85064324861&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85064324861&partnerID=8YFLogxK
U2 - 10.1016/j.rehab.2019.02.004
DO - 10.1016/j.rehab.2019.02.004
M3 - Article
AN - SCOPUS:85064324861
JO - Annals of Physical and Rehabilitation Medicine
JF - Annals of Physical and Rehabilitation Medicine
SN - 1877-0657
ER -