Middle-range scores from the patient determined disease steps scale reflect varying levels of walking dysfunction in multiple sclerosis.

IF 2.2 3区医学 Q3 CLINICAL NEUROLOGY

BMC Neurology Pub Date : 2024-10-10 DOI:10.1186/s12883-024-03871-1

Robert Motl, Whitney Neal, Deborah Backus, Jeffrey Hebert, Kevin McCully, Francois Bethoux, Prudence Plummer, Alexander Ng, John Lowman, Hollie Schmidt, Robert McBurney, Gary Cutter

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引用次数: 0

Abstract

Background: Multiple sclerosis (MS) is a leading cause of neurological disability among young and middle-aged adults worldwide, and disability is measured using a variety of approaches, including patient reported outcome measures (PROMs) such as the Patient Determined Disease Steps (PDDS) scale. There is limited evidence for the validity of inferences from the middle-range of scores on the PDDS (i.e., 3 "gait disability" - 6 "bilateral support"), but that range of scores seemingly represents moderate disability characterized by varying levels of walking dysfunction.

Purpose: The current study examined whether the middle-range of scores from the PDDS reflect varying levels of walking dysfunction among people with MS.

Method: Participants (N = 374) completed the Patient Determined Disease Steps (PDDS) scale, Multiple Sclerosis Walking Scale-12 (MSWS-12), timed 25-foot walk (T25FW), six-minute walk (6 MW), Modified Fatigue Impact Scale (MFIS), and Multiple Sclerosis Impact Scale-29 (MSIS-29), and underwent a neurological exam for generating an Expanded Disability Status Scale (EDSS) score as part of screening and baseline data collection for a clinical trial of exercise training in MS. We undertook a series of linear trend analyses that examined differences in the outcomes of EDSS, T25FW, 6 MW, MSWS-12, MFIS subscales, and MSIS-29 subscales across the 4 levels of PDDS scores (i.e., 3-6).

Results: There were statistically significant and strong linear trends for EDSS (F_1,370 = 306.1, p < .0001, η² = 0.48), T25FW (F_1,370 = 161.0, p < .0001, η² = 0.32), 6 MW (F_1,370 = 178.9, p < .0001, η² = 0.34), and MSWS-12 (F_1,370 = 97.0, p < .0001, η² = 0.24). There was a strong correlation between PDDS and EDSS scores (r_s = 0.695, 95% CI = 0.643, 0.748). Both PDDS and EDSS scores had strong correlations with walking outcomes, yet weaker correlations with measures of fatigue and QOL.

Conclusion: The PDDS could serve as a simple, inexpensive, and rapidly administered PROM for remote screening and early detection of walking dysfunction for initial eligibility into clinical trials and practice for managing mobility-specific disability in MS.

Registration: The study was registered on ClinicalTrials.gov on March 19, 2018 (NCT03468868).

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由患者确定的疾病步长量表的中档评分反映了多发性硬化症患者不同程度的行走功能障碍。

背景：多发性硬化症（MS）是导致全球中青年神经系统残疾的主要原因，残疾的测量方法多种多样，包括患者报告结果测量法（PROM），如患者自定疾病阶梯量表（PDDS）。从 PDDS 的中间分值（即 3 分 "步态残疾"-6 分 "双侧支持"）进行推断的有效性证据有限，但该分值范围似乎代表了以不同程度的行走功能障碍为特征的中度残疾。目的：本研究探讨了 PDDS 的中间分值是否反映了多发性硬化症患者不同程度的行走功能障碍：参与者（N = 374）完成了患者自定疾病步数量表（PDDS）、多发性硬化症行走量表-12（MSWS-12）、25英尺定时行走（T25FW）、6分钟行走（6 MW）、改良疲劳影响量表（MFIS）和多发性硬化症影响量表-29（MSIS-29），并接受了神经系统检查以生成扩展残疾状况量表（EDSS）评分，作为多发性硬化症运动训练临床试验筛选和基线数据收集的一部分。我们进行了一系列线性趋势分析，研究了EDSS、T25FW、6 MW、MSWS-12、MFIS分量表和MSIS-29分量表在PDDS评分的4个等级（即3-6）中的结果差异：EDSS（F1,370 = 306.1，P 2 = 0.48）、T25FW（F1,370 = 161.0，P 2 = 0.32）、6 MW（F1,370 = 178.9，P 2 = 0.34）和 MSWS-12 （F1,370 = 97.0，P 2 = 0.24）的线性趋势均具有统计学意义。PDDS 和 EDSS 评分之间存在很强的相关性（rs = 0.695，95% CI = 0.643，0.748）。PDDS 和 EDSS 评分与步行结果有很强的相关性，但与疲劳和 QOL 的相关性较弱：PDDS可作为一种简单、廉价、快速管理的PROM，用于远程筛查和早期发现行走功能障碍，以初步获得临床试验资格，并在实践中管理多发性硬化症的行动障碍：该研究于2018年3月19日在ClinicalTrials.gov上注册（NCT03468868）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Neurology 医学-临床神经学

CiteScore

4.20

自引率

0.00%

发文量

428

审稿时长

3-8 weeks

期刊介绍： BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.