Is it possible to achieve cross-cultural european agreement in the assessment of neurological deficits? First experiences in the european interferon-beta 1B trial for secondary progressive MS

Lechner-Scott, J.; Brunnschweiler, H; Kappos, L; Committee, The Study Steering

doi:10.1016/0165-5728(95)98993-l

Cited by 9 publications

(6 citation statements)

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“…In addition to these and other aspects, 11 the excessive weighting of the unaided walk in the EDSS has also been criticized by other authors. 12 In current trials, EDSS scoring is based on the Neurostatus by Kappos and co-workers, 13 which includes a structured neurological examination and improved guidelines for the functional systems. A consequent training of the investigators as well as a precise measurement of the unaided walking distance is strongly recommended.…”

Section: Discussionmentioning

confidence: 99%

Day-to-day variability of maximum walking distance in MS patients can mislead to relevant changes in the Expanded Disability Status Scale (EDSS): average walking speed is a more constant parameter

Albrecht¹,

Wötzel²,

Erasmus³

et al. 2001

Mult Scler

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In this preliminary study we measured maximum walking distance and walking time on four consecutive days in 29 patients with clinically stable multiple sclerosis (MS). Patients were included in the study if they could achieve a maximum unaided walking distance of 100 up to 500 m. Our results showed a certain day-to-day variability of maximum walking distance, in some cases meaning changes up to 1.5 points in the expanded disability status scale (EDSS), which could be misinterpreted as a progression of the disease. Simultaneous measurements of maximum walking time showed a similar variability, unlike the mean walking speed which turned out to be more stable. Our results therefore suggest that scoring of MS patients should not be based on one single measurement of the maximum walking distance. The more reliable parameter appears to be the mean walking speed.

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Section: Discussionmentioning

confidence: 99%

Day-to-day variability of maximum walking distance in MS patients can mislead to relevant changes in the Expanded Disability Status Scale (EDSS): average walking speed is a more constant parameter

Albrecht¹,

Wötzel²,

Erasmus³

et al. 2001

Mult Scler

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“…During the treatment period, the patient was encouraged to keep a dose diary to assure good compliance with treatment. The EDSS was performed by a Neurostatus [16]-certified neurologist.…”

Section: Methodsmentioning

confidence: 99%

Walking improvements with nabiximols in patients with multiple sclerosis

et al. 2015

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Recently, nabiximols was approved as a treatment in MS spasticity. Data leading to approval and clinical use of nabiximols, although widely recognised, are based on subjective scales. Movement analysis procedures would obtain more detailed data about the impact on mobility. The aim of the study was to quantitatively assess the functional modification of gait patterns induced by nabiximols in MS. We evaluated three-dimensional gait analysis (spatial-temporal and kinematic) variation by means of one-way ANOVA. Twenty patients were enrolled-9 male and 11 female-with mean EDSS of 5.3 (SD ± 0.81) and mean reduction of numerical rating scale during nabiximols treatment of 1.88. The spatial-temporal parameters of gait revealed an increased speed (+15 %, p < 0.001), cadence (+6 %, p < 0.001) and stride length (+10 %, p < 0.001) after treatment. Regarding the kinematics data, the Gait Profile Score after treatment was reduced by 10 % (p < 0.001): Significant changes involved the pelvic area, hip rotation and knee flexion-extension. We found that nabiximols is able to improve the speed, cadence and stride length. Furthermore, the dynamics of the proximal segment of the legs and the knee movement results after treatment are closer to the physiologic values.

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“…The result is a more coherent and understandable system which improves the overall sensitivity and reliability of assessments. 13 Other scales Among suggested scale the Scripps Neurological Rating Scale (NRS) 14 has been used in many trials. It is based mainly on the ®ndings of the standard neurological examination with a special category for bladder, bowel and sexual dysfunction.…”

Section: (E)dss-related Scalesmentioning

confidence: 99%

Quantification of impairment in MS: discussion of the scales in use

Amato

Ponziani

1999

Mult Scler

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Accurate, efficient measurement of disease status has become a key issue in MS clinical practice and research. Despite some perceived problems, the Expanded Disability Status Scale (EDSS) remains the most widely used comprehensive measure of impairment. There is also a place for more restricted scales of impairment which focus on some aspects of neurological function in more detail than the EDSS e.g. measures of ambulation, arm function and cognitive function. Improvements in scales of impairment in the future is likely to result from the use of more quantitative tests of selected components of the neurological examination.

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Is it possible to achieve cross-cultural european agreement in the assessment of neurological deficits? First experiences in the european interferon-beta 1B trial for secondary progressive MS

Cited by 9 publications

References 0 publications

Day-to-day variability of maximum walking distance in MS patients can mislead to relevant changes in the Expanded Disability Status Scale (EDSS): average walking speed is a more constant parameter

Day-to-day variability of maximum walking distance in MS patients can mislead to relevant changes in the Expanded Disability Status Scale (EDSS): average walking speed is a more constant parameter

Walking improvements with nabiximols in patients with multiple sclerosis

Quantification of impairment in MS: discussion of the scales in use

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