Responsiveness of walking-based outcome measures after multiple sclerosis relapses following steroid pulses

Grčić, Petar Filipović; Matijaca, Meri; Lušić, Ivo; Čapkun, Vesna

doi:10.12659/msm.882130

Cited by 16 publications

(11 citation statements)

References 30 publications

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“…We found low responsiveness of the T25FW, which is comparable to a prior study, which reported that the T25FW had a standardized response mean (SRM) of 0.55 and an effect size of 0.27 following intravenous methylprednisolone therapy for acute relapse in 49 people with MS (EDSS 1.0-6.0) 30. The same study reported that the MSWS-12 was highly responsive (SRM = 1.05, effect size = 1.02), whereas we found the MSWS-12 to be only moderately responsive 30. It is possible that patient-perceived changes of the impact of MS on their walking after treatment with methylprednisolone for an acute relapse were perceived as larger on the MSWS-12 than those elicited by our physical therapy intervention in people with stable disease.…”

Section: Discussionsupporting

confidence: 82%

“…We also chose to evaluate responsiveness in the T25FW and the MSWS-12, as these are highly recommended outcomes for MS rehabilitation 6. We found low responsiveness of the T25FW, which is comparable to a prior study, which reported that the T25FW had a standardized response mean (SRM) of 0.55 and an effect size of 0.27 following intravenous methylprednisolone therapy for acute relapse in 49 people with MS (EDSS 1.0-6.0) 30. The same study reported that the MSWS-12 was highly responsive (SRM = 1.05, effect size = 1.02), whereas we found the MSWS-12 to be only moderately responsive 30.…”

Section: Discussionsupporting

confidence: 64%

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Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis

Mañago

Cohen

Cameron

et al. 2023

Journal of Neurologic Physical Therapy

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Background and Purpose: This study's purpose was to investigate the reliability, validity, and responsiveness of the Patient-Specific Functional Scale (PSFS) for measuring mobility-related goals in people with multiple sclerosis (MS). Methods: Data from 32 participants with MS who underwent 8 to 10 weeks of rehabilitation were analyzed (Expanded Disability Status Scale scores 1.0-7.0). For the PSFS, participants identified 3 mobility-related areas where they had difficulty and rated them at baseline, 10 to 14 days later (before starting intervention), and immediately after intervention. Test-retest reliability and response stability of the PSFS were calculated using the intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC95), respectively. Concurrent validity of the PSFS was determined with the 12-item Multiple Sclerosis Walking Scale (MSWS-12) and the Timed 25-Foot Walk Test (T25FW). PSFS responsiveness was determined using Cohen's d, and minimal clinically important difference (MCID) was calculated based on patient-reported improvements on a Global Rating of Change (GRoC) scale. Results: The PSFS total score demonstrated moderate reliability (ICC2,1 = 0.70, 95% CI: 0.46 to 0.84) and the MDC was 2.1 points. At baseline, the PSFS was fairly and significantly correlated with the MSWS-12 (r = −0.46, P = 0.008) but not with the T25FW. Changes in the PSFS were moderately and significantly correlated with the GRoC scale (ρ = 0.63, P < 0.001), but not with MSWS-12 or T25FW changes. The PSFS was responsive (d = 1.7), and the MCID was 2.5 points or more to identify patient-perceived improvements based on the GRoC scale (sensitivity = 0.85, specificity = 0.76). Discussion and Conclusions: This study supports the use of the PSFS as an outcome measure in people with MS to assess mobility-related goals. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A423).

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 64%

Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis

Mañago

Cohen

Cameron

et al. 2023

Journal of Neurologic Physical Therapy

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“…( ) and Jensen et al ( ) both showed a larger change in walking time between before and after treatment using the SSST than the T25FW. Filipovic Grcic et al ( ) also showed a larger relative efficiency of the SSST than the T25FW, and the difference between the two was of similar size as in our study.…”

Section: Discussionmentioning

confidence: 90%

The six‐spot‐step test – a new method for monitoring walking ability in patients with chronic inflammatory polyneuropathy

Kreutzfeldt

Jensen

Ravnborg

et al. 2017

J Peripheral Nervous Sys

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The aim of this study was to evaluate whether the six-spot-step test (SSST) is more suitable for monitoring walking ability in patients with chronic inflammatory polyneuropathy than the timed 25-foot-walking test (T25FW). In the SSST, participants have to walk as quickly as possible across a field measuring 1 × 5 m, while kicking blocks out of five circles on the floor. Sixty-two patients and 61 controls performed the SSST and T25FW. Patients also performed the overall disability sumscore, INCAT sensory sumscore, Medical Research Council sumscore, and 9-hole-peg-test. Twenty-one patients treated with intravenous immunoglobulin (IVIG) every 4-6 weeks were tested prior to and 2-3 weeks after treatment and judged change in their own clinical condition using the patient global impression of change (PGIC) scale. In patients, SSST ranged from 5.7 to 26.8 s and T25FW ranged from 3.6 to 12.9 s. Intra-class correlation between repeated tests was 0.97 for SSST and 0.95 for T25FW. Correlation with the additional tests was stronger for SSST than T25FW. In IVIG-treated patients, the mean change in walking time was -2.3 s for SSST and -0.6 s for T25FW. The SSST showed larger responsiveness in terms of effect size, standardized response means, and relative efficiency. Both ambulation tests correlated moderately to PGIC. The SSST may be superior to the T25FW in terms of dynamic range, floor effect, and responsiveness which makes the SSST a possible alternative for monitoring walking ability in patients with chronic inflammatory polyneuropathy.

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“…This would support the idea that such MCID values for steps/day are attainable in clinical research involving persons with MS who take part in a physical activity intervention, and perhaps other therapeutic interventions. Importantly, we are aware of one study that reported a change of ∼600 steps/day one month after treatment for a relapse using intravenous methylprednisolone therapy in 49 consecutive patients with RRMS [20].…”

Section: Discussionmentioning

confidence: 99%

Clinical Importance of Steps Taken per Day among Persons with Multiple Sclerosis

et al. 2013

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BackgroundThe number of steps taken per day (steps/day) provides a reliable and valid outcome of free-living walking behavior in persons with multiple sclerosis (MS).ObjectiveThis study examined the clinical meaningfulness of steps/day using the minimal clinically important difference (MCID) value across stages representing the developing impact of MS.MethodsThis study was a secondary analysis of de-identified data from 15 investigations totaling 786 persons with MS and 157 healthy controls. All participants provided demographic information and wore an accelerometer or pedometer during the waking hours of a 7-day period. Those with MS further provided real-life, health, and clinical information and completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and Patient Determined Disease Steps (PDDS) scale. MCID estimates were based on regression analyses and analysis of variance for between group differences.ResultsThe mean MCID from self-report scales that capture subtle changes in ambulation (1-point change in PDSS scores and 10-point change in MSWS-12 scores) was 779 steps/day (14% of mean score for MS sample); the mean MCID for clinical/health outcomes (MS type, duration, weight status) was 1,455 steps/day (26% of mean score for MS sample); real-life anchors (unemployment, divorce, assistive device use) resulted in a mean MCID of 2,580 steps/day (45% of mean score for MS sample); and the MCID for the cumulative impact of MS (MS vs. control) was 2,747 steps/day (48% of mean score for MS sample).ConclusionThe change in motion sensor output of ∼800 steps/day appears to represent a lower-bound estimate of clinically meaningful change in free-living walking behavior in interventions of MS.

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Responsiveness of walking-based outcome measures after multiple sclerosis relapses following steroid pulses

Cited by 16 publications

References 30 publications

Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis

Reliability, Validity, and Responsiveness of the Patient-Specific Functional Scale for Measuring Mobility-Related Goals in People With Multiple Sclerosis

The six‐spot‐step test – a new method for monitoring walking ability in patients with chronic inflammatory polyneuropathy

Clinical Importance of Steps Taken per Day among Persons with Multiple Sclerosis

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