Assessment set for evaluation of clinical outcomes in multiple sclerosis: psychometric properties

Abstract

Purpose:Multiple sclerosis (MS) manifests itself in a wide range of symptoms. Physiotherapy plays an important role in the treatment of those symptoms connected with mobility. For this therapy to be at its most effective it should be based on a systematic examination that is able to describe and classify damaged clinical functions meaningfully. The purpose of this study was to develop and validate a battery of tests and composite tests that can be used to systematically evaluate clinical features of MS treatable by physiotherapy.Methods:The authors assembled a proposed battery of tests comprising known, standard, and validated assessments (low-contrast letter acuity testing; the Motricity Index; the Modified Ashworth Scale; the Berg Balance Scale; scales of postural reactions, tremor, dysdiadochokinesia, and dysmetria; the Nine-Hole Peg Test; the Timed 25-Foot Walk; and the 3-minute version of the Paced Auditory Serial Addition Test) and one test (knee hyperextension) of the authors’ own. Normalization was calculated and six composite assessments were measured. Seventeen ambulatory subjects with MS were tested twice with the assessment set before undergoing physiotherapy, and 12 were also tested with the assessment set after the physiotherapy. The test–retest reliability, stability, internal consistency of composite measurements, sensitivity to changes after therapy, and correlation between measurements and the Kurtzke Expanded Disability Status Scale score were evaluated for all tests in the assessment set.Results:A good internal consistency was confirmed for all tests in the proposed battery, and most of the tests also showed good test–retest reliability. While no significant changes occurred without treatment, significant posttreatment improvement was proved in all tests except for low-contrast letter acuity testing, where only a trend to improvement was proved.Conclusion:The proposed assessment set is a good tool for the evaluation of clinical features of MS treatable by physiotherapy. This battery of tests is applicable in both clinical practice and research.

Effects of Functional Electrical Stimulation on Gait Function and Quality of Life for People with Multiple Sclerosis Taking Dalfampridine

“…The T25FW test is considered a reliable, objective measure of walking disability 18 and is one of the most frequently used measures to assess gait function in people with MS. 19 Participants are instructed to walk 25 feet at their fastest safe speed; they may use assistive devices. The seen in this study are thought to be attributable to the effects of FES.…”

Effects of Torso-Weighting on Standing Balance and Falls During the Sensory Organization Test in People with Multiple Sclerosis

“…Participants wore a safety harness while standing for the SOT, a type of computerized dynamic posturography. This was followed by three additional clinical tests performed in random order: the Timed Up and Go test, 25 the Timed 25-Foot Walk test, 26 and the Dynamic Gait Index. 25 Participants then underwent torsoweighting using the Balance-Based Torso-Weighting method, followed by a rest break of at least 20 minutes before continuing testing.…”

Neurorehabilitation Topics in Patients with Multiple Sclerosis: From Outcome Measurements to Rehabilitation Interventions

“…The MAS has good interrater reliability and internal consistency. 36 However, it has poor test-retest reliability 37 and is not sensitive to detect changes in QoL or functional outcomes. 38 The Numeric Rating Scale (NRS) is another measure of spasticity in MS. 37 It is a patient-rated numeric rating scale from 0 to 10 that can be used as a measure of the perceived severity of spasticity in MS patients showing good validity and reliability.…”

“…36 However, it has poor test-retest reliability 37 and is not sensitive to detect changes in QoL or functional outcomes. 38 The Numeric Rating Scale (NRS) is another measure of spasticity in MS. 37 It is a patient-rated numeric rating scale from 0 to 10 that can be used as a measure of the perceived severity of spasticity in MS patients showing good validity and reliability. 39 A reduction of approximately 30% best represented a clinically important difference, and a change of 18% a minimal clinically important difference.…”