Walking measures to evaluate assistive technology for foot drop in multiple sclerosis: A systematic review of psychometric properties

Andreopoulou, Georgia; Mercer, Thomas H.; Linden, Marietta van der

doi:10.1016/j.gaitpost.2017.12.021

Cited by 10 publications

(9 citation statements)

References 88 publications

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“…Three-dimensional gait analysis (3DGA) through motion capture systems is an established method to quantify and reveal even minimal gait disorders in a variety of populations and has been considered the 'gold' standard in terms of quantitative gait analysis [6][7]. A recent systematic review reported that 3DGA is one of the most common outcome measures used to evaluate walking performance in MS population [8]. In recent years, there has been an increasing focus on the characterisation of gait pattern in pwMS through 3D kinematics [9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, despite 3D ankle kinematics being one of the most frequently used outcome measures to assess the effects of assistive technology on foot drop, no studies reporting on its psychometric properties were identified for the MS population [8] even though it is considered a 'gold standard' for the assessment of walking performance [6].…”

Section: Introductionmentioning

confidence: 99%

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Test-retest reliability and minimal detectable change of ankle kinematics and spatiotemporal parameters in MS population

et al. 2019

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Background Many people with multiple sclerosis (pwMS) experience walking impairments often including foot drop, evident as either reduced dorsiflexion at initial contact and/or at the swing phase of the gait cycle. To measure even subtle differences in ankle kinematics 3D gait analysis is considered a 'gold' standard. However, the psychometric properties of ankle kinematics in the MS population have not yet been examined. Objective The aim of the study was to examine test-retest relative and absolute reliability of sagittal ankle kinematics and spatiotemporal parameters in two groups of pwMS with different levels of walking impairment. Methods Two groups of pwMS underwent 3D gait analysis on two occasions 7 to 14 days apart. Group A consisted of 21 (14 female) people with Expanded Disability Status Scale (EDSS) 1-3.5 and group B consisted of 28 participants (14 female) with EDSS 4-6. The Intraclass Correlation Coefficient (ICC2,2), standard error of measurement (SEM) and minimal detectable change (MDC95%) were calculated for peak dorsiflexion (DF) in swing, ankle angle at initial contact (IC), gait profile score (GPS), walking speed, cadence and step length.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Test-retest reliability and minimal detectable change of ankle kinematics and spatiotemporal parameters in MS population

et al. 2019

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“…Although the 6-minute Walk Test has been found to be an accurate walking performance test to assess the benefits of assistive technology for foot drop in Multiple Sclerosis 47 , the validity and reliability of our primary outcome, the 5-minute self-selected walk test, has not been established. This is a significant limitation of this study.…”

Section: Discussionmentioning

confidence: 99%

The clinical- and cost-effectiveness of functional electrical stimulation and ankle-foot orthoses for foot drop in Multiple Sclerosis: a multicentre randomized trial

et al. 2019

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Objective: To compare the clinical- and cost-effectiveness of ankle-foot orthoses (AFOs) and functional electrical stimulation (FES) over 12 months in people with Multiple Sclerosis with foot drop. Design: Multicentre, powered, non-blinded, randomized trial. Setting: Seven Multiple Sclerosis outpatient centres across Scotland. Subjects: Eighty-five treatment-naïve people with Multiple Sclerosis with persistent (>three months) foot drop. Interventions: Participants randomized to receive a custom-made, AFO (n = 43) or FES device (n = 42). Outcome measures: Assessed at 0, 3, 6 and 12 months; 5-minute self-selected walk test (primary), Timed 25 Foot Walk, oxygen cost of walking, Multiple Sclerosis Impact Scale-29, Multiple Sclerosis Walking Scale-12, Modified Fatigue Impact Scale, Euroqol five-dimension five-level questionnaire, Activities-specific Balance and Confidence Scale, Psychological Impact of Assistive Devices Score, and equipment and National Health Service staff time costs of interventions. Results: Groups were similar for age (AFO, 51.4 (11.2); FES, 50.4(10.4) years) and baseline walking speed (AFO, 0.62 (0.21); FES 0.73 (0.27) m/s). In all, 38% dropped out by 12 months (AFO, n = 21; FES, n = 11). Both groups walked faster at 12 months with device (P < 0.001; AFO, 0.73 (0.24); FES, 0.79 (0.24) m/s) but no difference between groups. Significantly higher Psychological Impact of Assistive Devices Scores were found for FES for Competence (P = 0.016; AFO, 0.85(1.05); FES, 1.53(1.05)), Adaptability (P = 0.001; AFO, 0.38(0.97); FES 1.53 (0.98)) and Self-Esteem (P = 0.006; AFO, 0.45 (0.67); FES 1 (0.68)). Effects were comparable for other measures. FES may offer value for money alternative to usual care. Conclusion: AFOs and FES have comparable effects on walking performance and patient-reported outcomes; however, high drop-outs introduces uncertainty.

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“…For testing walking speed in MS, the best known and currently most widely used test is the T25FW. It is considered one of the most sensitive and reproducible instruments with good validity for quantifying walking ability by measuring the time taken to cover 7.62 m (Cohen et al, 2000;Andreopoulou et al, 2018;Sikes et al, 2020). The examiner first measures and marks the distance and stops the time the patient needs to cover the distance twice.…”

Section: Assessment Of Walking Speedmentioning

confidence: 99%

The Dresden Protocol for Multidimensional Walking Assessment (DMWA) in Clinical Practice

et al. 2020

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Walking impairments represent one of the most debilitating symptom areas for people with multiple sclerosis (MS). It is important to detect even slightest walking impairments in order to start and optimize necessary interventions in time to counteract further progression of the disability. For this reason, a regular monitoring through gait analysis is highly necessary. At advanced stages of MS with significant walking impairment, this assessment is also necessary to optimize symptomatic treatment, choose the most suitable walking aid and plan individualized rehabilitation. In clinical practice, walking impairment is only assessed at higher levels of the disease using e.g., the Expanded Disability Status Scale (EDSS). In contrast to the EDSS, standardized functional tests such as walking speed, walking endurance and balance as well as walking quality and gait-related patient-reported outcomes allow a more holistic and sensitive assessment of walking impairment. In recent years, the MS Center Dresden has established a standardized monitoring procedure for the routine multidimensional assessment of gait and balance disorders. In the following protocol, we present the techniques and procedures for the analysis of gait and balance of people with MS at the MS Center Dresden. Patients are assessed with a multidimensional gait analysis at least once a year. This enables long-term monitoring of walking impairment, which allows early active intervention regarding further progression of disease and improves the current standard clinical practice.

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Walking measures to evaluate assistive technology for foot drop in multiple sclerosis: A systematic review of psychometric properties

Cited by 10 publications

References 88 publications

Test-retest reliability and minimal detectable change of ankle kinematics and spatiotemporal parameters in MS population

Test-retest reliability and minimal detectable change of ankle kinematics and spatiotemporal parameters in MS population

The clinical- and cost-effectiveness of functional electrical stimulation and ankle-foot orthoses for foot drop in Multiple Sclerosis: a multicentre randomized trial

The Dresden Protocol for Multidimensional Walking Assessment (DMWA) in Clinical Practice

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