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: 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.