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Responsiveness and minimal clinically important difference of TNO-AZL Preschool Children Quality of Life in children with cerebral palsy

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Abstract

Purpose

To examine the responsiveness and minimal clinically important difference (MCID) of the TNO-AZL (Netherlands Organization for Applied Scientific Research Academic Medical Centre) Preschool Children Quality of Life (TAPQOL) in children with cerebral palsy (CP).

Methods

Ninety-seven children with CP (60 males, 37 females; aged 1–6 years) and their caregivers were recruited from the rehabilitation programs of Chang Gung Memorial Hospital in Taiwan for this 6-month longitudinal follow-up study. The Functional Independence Measure for Children (WeeFIM) and TAPQOL outcomes were measured at baseline and at a 6-month follow-up. Responsiveness was examined using the standardized response mean (SRM). The distribution-based and anchor-based MCID were determined. The TAPQOL outcomes include physical functioning (PF), social functioning (SF), cognitive functioning (CF), and emotional functioning (EF) domains.

Results

The responsiveness of the TAPQOL for all of TAPQOL domains was marked (SRM = 1.12–1.54). The anchor-based MCIDs of TAPQOL for PF, SF, CF, EF, and total domains were 1.25, 3.28, 2.93, 2.25, and 1.73, respectively, which were similar to the distribution-based MCID values of TAPQOL, except in the PF domain. The distribution-based MCIDs of TAPQOL in various domains were 2.85–3.73 when effect size (ES) was 0.2, 7.13–9.32 when ES was 0.5, and 11.40–14.91 when ES was 0.8.

Conclusions

TAPQOL is markedly responsive to detect change in children with CP. The caregivers perceived the minimally important change in HRQOL of their children at a relatively low treatment efficacy. Researchers and clinicians can utilize TAPQOL data to determine whether changes in TAPQOL scores indicate clinically meaningful effects post-treatment and at the follow-up.

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Author notes

  1. Chia-Ling Chen and I-hsuan Shen have contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 5 Fu-Hsing St. Kwei-Shan, Tao-Yuan, 333, Taiwan

    Chia-ling Chen, I-hsuan Shen, Hsiang-Han Huang & Ching-yi Wu

  2. Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd, Kwei-Shan, Tao-Yuan, 333, Taiwan

    Chia-ling Chen & Yi-ting Hsiao

  3. Department of Occupational Therapy, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd, Kwei-Shan, Tao-Yuan, 333, Taiwan

    I-hsuan Shen, Hsiang-Han Huang & Ching-yi Wu

  4. Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, 222 Maijin Rd, Keelung, 204, Taiwan

    Chung-yao Chen

  5. School of Medicine, College of Medicine, Chang Gung University, 259 Wen-Hwa 1st Rd, Kwei-Shan, Tao-Yuan, 333, Taiwan

    Chung-yao Chen

  6. Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan

    Hsieh-Ching Chen

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  1. Chia-ling Chen
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Chen, Cl., Shen, Ih., Huang, HH. et al. Responsiveness and minimal clinically important difference of TNO-AZL Preschool Children Quality of Life in children with cerebral palsy. Qual Life Res 29, 825–831 (2020). https://doi.org/10.1007/s11136-019-02370-y

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