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Minimal Clinically Important Difference of Berg Balance Scale scores in people with acute stroke
Phys Ther Rehabil Sci 2018;7:102-8
Published online September 30, 2018
© 2018 Korean Academy of Physical Therapy Rehabilitation Science.

Min-Jeong Songa,b, Jae-Hyoung Leeb, Won-Seob Shina

aDepartment of Physical Therapy, Graduate School of Daejeon University, Daejeon, Republic of Korea
bDepartment of Physical Therapy, Wonkwang Health Science University, Iksan, Republic of Korea
Correspondence to: Won-Seob Shin (ORCID
Department of Physical Therapy, Graduate School of Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
Tel: 82-42-280-2290 Fax: 82-42-280-2295 E-mail:
Received May 28, 2018; Revised June 13, 2018; Accepted June 19, 2018.
cc This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation.
Design: Retrospective study.
Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cut-off values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups.
Results: The optimal MCID cut-off point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively.
Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.
Keywords : Minimal clinically important difference, Retrospective study, Stroke


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