Minimal detectable change and minimal important change of the simple test for evaluating hand function in patients with subacute stroke.

OBJECTIVE

To investigate the minimal detectable change (MDC) and minimal important change (MIC) of the Simple Test for Evaluating Hand Function (STEF) in patients with subacute stroke.

DESIGN AND

SETTING

Prospective longitudinal study at a single rehabilitation hospital.

PARTICIPANTS

Fifty-three patients with subacute stroke.

INTERVENTION: Patients received standard stroke rehabilitation, including physical, occupational, and speech therapy. Upper extremity function was assessed using the STEF at admission, the next day, and 4 weeks later.

MAIN MEASURES: The primary outcome was the STEF score. Additional measures were the Global Rating of Change Scale (GRCS), the Functional Independence Measure (FIM) self-care domain, and the Modified Rankin Scale (mRS). Test - retest reliability and MDC were calculated. MIC was estimated using an anchor-based receiver operating characteristic analysis and an adjusted logistic regression approach.

RESULTS

The STEF showed excellent reliability, with an intraclass correlation coefficient of 0.98 and a MDC95 of 12.7 points. Anchor-based MIC values were 14.5 points for participants' GRCS, 9.0 points for therapists' GRCS, 11.5 points for the FIM self-care domain, and 16.0 points for the mRS. Adjusted predictive values were 7.9, 8.6, 9.5, and 16.6 points, respectively.

CONCLUSIONS

A change greater than 12 points on the STEF likely exceeds measurement error. These thresholds support interpretation of patient changes and guide clinical decision-making in subacute stroke rehabilitation.