Clinimetric evaluation of a new overall disability scale in immune mediated polyneuropathies

Abstract

Objectives: To determine the validity, reliability, and responsiveness of a new overall disability sum score in immune mediated polyneuropathies. Methods: Three impairment measures (MRC sum score, sensory sum score, grip strength (Vigorimeter)) and three disability scales (an overall disability sum score (ODSS), Hughes' functional scale (f score), Rankin scale) were assessed in a cross sectional group of 113 clinically stable patients (83 with Guillain-Barré syndrome, 22 with chronic inflammatory demyelinating polyneuropathy (CIDP), eight with a gammopathy related polyneuropathy). The ODSS was also used serially in 20 patients with recently diagnosed Guillain-Barré syndrome (n = 7) or CIDP (n = 13) and changing clinical conditions. Multiple regression studies were performed to compare the impact of impairment disturbances (independent variables) on the various disability scales (dependent variable). Results: Moderate to good construct validity (stable group: Spearman's rank test (absolute values), r = 0.41-0.79; longitudinal group: multiple correlation coefficient, R = 0.69-0.89; p < 0.006 for all associations) and reliability (intraclass correlation coefficient, R = 0.90-0.95; p < 0.0001) were demonstrated for the ODSS. Its SRM values were high (> 0.8), indicating good responsiveness. Impairment measures accounted for a higher variance proportion of the ODSS compared with the f score and Rankin (R = 0.64 v 0.56 and 0.45, respectively). Conclusions: All clinimetric requirements were met by the overall (arm and leg) disability sum score in immune mediated polyneuropathies. Its use is therefore suggested in evaluating immune mediated polyneuropathies.

Connecting impairment, disability, and handicap in immune mediated polyneuropathies

“…14 15 The overall disability sum score (ODSS) is derived from a recent arm and leg disability scale, with a total score ranging from 0 ("no sign of disability") to 12 ("most severe disability"). 16 The ODSS comprises a good functional description of the arms and legs in checklist form suitable for interviewing patients. Daily arm activities such as dressing the upper part of the body, doing up and undoing buttons and zips, washing and brushing the hair, using a knife and fork, and turning a key in a lock are investigated.…”

“…Problems with walking are also evaluated taking into account the use of a walking aid. 16 The ODSS, its arm disability scale, and its leg disability scale were examined separately in the univariate regression analyses to determine their association with the handicap level.…”

Treatment of patients with multifocal motor neuropathy with immunoglobulins in clinical practice: the SIGNS registry

“…INCAT, inflammatory neuropathy cause and treatment. Arm disability 0 No upper limb problems 1 Symptoms, in one or both arms, not affecting the ability to perform any of the following functions: doing all zips and buttons; washing or brushing hair; using a knife and fork together; handling small coins 2 Symptoms, in one arm or both arms, affecting but not preventing any of the abovementioned functions 3 Symptoms, in one arm or both arms, preventing one or two of the abovementioned functions 4 Symptoms, in one arm or both arms, preventing three or all of the functions listed, but some purposeful movements still possible 5 Inability to use either arm for any purposeful movement Leg disability 0 Walking not affected 1 Walking affected, but walks independently outdoors 2 Usually uses unilateral support (stick, single crutch, one arm) to walk outdoors 3 Usually uses bilateral support (sticks, crutches, frame, two arms) to walk outdoors 4 Usually uses wheelchair to travel outdoors, but able to stand and walk a few steps with help 5 Restricted to wheelchair, unable to stand and walk a few steps with help Source: Merkies et al [2002]. …”

Efficacy of lenalidomide plus dexamethasone for POEMS syndrome relapsed after autologous peripheral stem‐cell transplantation

“…After transplant, complementary radiotherapy to the left homerus was administered. He obtained a hematologic partial remission [25][26][27], with the persistence of serum M-protein detected by immunofixation and a consistent improvement of the neuropathy with ability to walk and disappearance of pain. Then, he was followed for 6 years as outpatient, maintaining a hematologic partial response until June 2010.…”