MCID of 6 commonly-used performance tests in patients with chronic musculoskeletal pain
Background Functional tests are widely used to measure performance in patients with chronic musculoskeletal pain. Our objective was to determine the Minimal Clinically Important Differences (MCID) for the 6-minute walk test (6MWT), the Steep Ramp Test (SRT), the 1-minute stair climbing test (1MSCT), the sit-to-stand test (STS), the Jamar dynamometer test (JAM) and the lumbar Progressive Isoinertial Lifting Evaluation (PILE) in chronic musculoskeletal pain patients. Methods A single-center prospective observational study was conducted in a rehabilitation center. Patients with upper-limb, lower-limb or neck/back lesions were included over a period of 21 months. The anchor-based, distribution-based and opinion-based approaches were used to determine the MCIDs. Results 838 chronic musculoskeletal pain patients were included. The estimation method and the lesion location had a significant influence on the results. MCIDs were estimated at +75m and +62m for the 6MWT (lower-limb and neck/back lesions, respectively), +18 steps and +19 steps for the 1MSCT (lower-limb and neck/back lesions, respectively) and +6kg for the JAM. The anchor-based method could not provide valid estimations for the three other scales, but distribution and opinion-based methods provided rough values of MCIDs for the SRT (+44w to +61w), the STS (-6 sec to -9 sec) and the PILE (+4kg to +7kg). Conclusion The above MCID estimations for the 6MWT, 1MSCT and JAM can be used in chronic musculoskeletal pain patients participating in vocational multidisciplinary rehabilitation programs or in therapeutic trials. The use of specific anchors might give better estimations of MCIDs for the three other scales in future research.