Sensitivity to change and minimal clinically important difference of the Locomotor Capabilities Index-5 in people with lower limb amputation undergoing prosthetic training

Franco Franchignoni, Marco Traballesi, Marco Monticone, Andrea Giordano, Stefano Brunelli, Giorgio Ferriero

Research output: Contribution to journalArticle

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 [ICC2,1]=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 languageEnglish
Pages (from-to)137-141
Number of pages5
JournalAnnals of Physical and Rehabilitation Medicine
Volume62
Issue number3
DOIs
Publication statusPublished - May 2019

Keywords

  • Aged
  • Amputation/rehabilitation
  • Artificial Limbs
  • Female
  • Humans
  • Locomotion/physiology
  • Lower Extremity/physiopathology
  • Male
  • Middle Aged
  • Minimal Clinically Important Difference
  • Prospective Studies
  • Reproducibility of Results
  • Surveys and Questionnaires/standards

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