Estimating the minimum clinically important difference (MCID) of the five-repetition sit-to-stand test in patients with lumbar disc herniation.

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
European Spine Journal Pub Date : 2025-03-01 Epub Date: 2024-12-16 DOI:10.1007/s00586-024-08582-2
Anita M Klukowska, Manon G Dol, W Peter Vandertop, Marc L Schröder, Victor E Staartjes
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引用次数: 0

Abstract

Background: The impact of surgical interventions on lumbar disc herniation (LDH) is often assessed using objective functional impairment (OFI) tests like the five-repetition sit-to-stand (5R-STS) test. This study calculates the minimum clinically important difference (MCID) for 5R-STS improvement in patients with LDH one year after surgery.

Methods: Adult patients with LDH scheduled for surgery were prospectively recruited from a Dutch short-stay spinal clinic. The 5R-STS time, Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), Numeric Rating Scale for back and leg pain, EQ-5D-3L health-related quality of life questionnaire and EQ5D-VAS were recorded preoperatively, at 6-weeks and 1-year post-operatively. The MCID was calculated using anchor-based methods (within-patient change; between-patient change; and receiver-operating characteristic approaches) and distribution-based methods (0.5 standard deviation (SD); effect size; standard error of measurement; standardized response mean; and 95% minimum detectable change (MDC)). The final MCID value was based on the "gold standard": an averaging of the anchor-based methods using ODI and RMDQ as the closest available anchors.

Results: We prospectively recruited 134 patients. One-year follow-up was completed by 103 (76.8%) of patients. The MCID values derived using different methods varied from 0.7 to 5.1 s (s). The final, averaged, anchor-based MCID for improvement was 3.6 s. Within distribution-based methods, 95% MDC and 0.5SD approach, yielded an MCID of 3.0 and 3.8 s, respectively, aligning closely with the overall anchor-derived MCID for 5R-STS.

Conclusion: In a patient with LDH, an improvement in 5R-STS performance of at least 3.6 s can be regarded as a clinically relevant improvement.

估算腰椎间盘突出症患者五次重复坐立测试的最小临床重要差异 (MCID)。
背景:手术干预对腰椎间盘突出症(LDH)的影响通常通过客观功能障碍(OFI)测试(如五次重复坐立(5R-STS)测试)进行评估。本研究计算了 LDH 患者术后一年 5R-STS 改善的最小临床重要差异(MCID):方法:从荷兰一家短期脊柱诊所招募计划接受手术的 LDH 成人患者。术前、术后 6 周和术后 1 年分别记录 5R-STS 时间、Oswestry 残疾指数(ODI)、Roland-Morris 残疾问卷(RMDQ)、腰腿痛数字评分量表、EQ-5D-3L 健康相关生活质量问卷和 EQ5D-VAS。使用基于锚的方法(患者内变化、患者间变化和接收者操作特征法)和基于分布的方法(0.5 标准差 (SD)、效应大小、测量标准误差、标准化反应平均值和 95% 最小可检测变化 (MDC))计算 MCID。最终的MCID值基于 "黄金标准":以ODI和RMDQ为最接近的锚点,对基于锚点的方法进行平均:我们前瞻性地招募了 134 名患者。103名患者(76.8%)完成了为期一年的随访。使用不同方法得出的 MCID 值从 0.7 到 5.1 秒(s)不等。在基于分布的方法中,95% MDC 和 0.5SD 方法得出的 MCID 分别为 3.0 和 3.8 秒,与 5R-STS 的总体锚定 MCID 非常接近:结论:对于 LDH 患者,5R-STS 性能至少提高 3.6 秒可被视为具有临床意义的改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Spine Journal
European Spine Journal 医学-临床神经学
CiteScore
4.80
自引率
10.70%
发文量
373
审稿时长
2-4 weeks
期刊介绍: "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe
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