Robert Motl, Whitney Neal, Deborah Backus, Jeffrey Hebert, Kevin McCully, Francois Bethoux, Prudence Plummer, Alexander Ng, John Lowman, Hollie Schmidt, Robert McBurney, Gary Cutter
{"title":"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。","authors":"Robert Motl, Whitney Neal, Deborah Backus, Jeffrey Hebert, Kevin McCully, Francois Bethoux, Prudence Plummer, Alexander Ng, John Lowman, Hollie Schmidt, Robert McBurney, Gary Cutter","doi":"10.1186/s12883-024-03871-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>The current study examined whether the middle-range of scores from the PDDS reflect varying levels of walking dysfunction among people with MS.</p><p><strong>Method: </strong>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).</p><p><strong>Results: </strong>There were statistically significant and strong linear trends for EDSS (F<sub>1,370</sub> = 306.1, p < .0001, η<sup>2</sup> = 0.48), T25FW (F<sub>1,370</sub> = 161.0, p < .0001, η<sup>2</sup> = 0.32), 6 MW (F<sub>1,370</sub> = 178.9, p < .0001, η<sup>2</sup> = 0.34), and MSWS-12 (F<sub>1,370</sub> = 97.0, p < .0001, η<sup>2</sup> = 0.24). There was a strong correlation between PDDS and EDSS scores (r<sub>s</sub> = 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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Registration: </strong>The study was registered on ClinicalTrials.gov on March 19, 2018 (NCT03468868).</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"24 1","pages":"383"},"PeriodicalIF":2.2000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465610/pdf/","citationCount":"0","resultStr":"{\"title\":\"Middle-range scores from the patient determined disease steps scale reflect varying levels of walking dysfunction in multiple sclerosis.\",\"authors\":\"Robert Motl, Whitney Neal, Deborah Backus, Jeffrey Hebert, Kevin McCully, Francois Bethoux, Prudence Plummer, Alexander Ng, John Lowman, Hollie Schmidt, Robert McBurney, Gary Cutter\",\"doi\":\"10.1186/s12883-024-03871-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>The current study examined whether the middle-range of scores from the PDDS reflect varying levels of walking dysfunction among people with MS.</p><p><strong>Method: </strong>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).</p><p><strong>Results: </strong>There were statistically significant and strong linear trends for EDSS (F<sub>1,370</sub> = 306.1, p < .0001, η<sup>2</sup> = 0.48), T25FW (F<sub>1,370</sub> = 161.0, p < .0001, η<sup>2</sup> = 0.32), 6 MW (F<sub>1,370</sub> = 178.9, p < .0001, η<sup>2</sup> = 0.34), and MSWS-12 (F<sub>1,370</sub> = 97.0, p < .0001, η<sup>2</sup> = 0.24). There was a strong correlation between PDDS and EDSS scores (r<sub>s</sub> = 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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Registration: </strong>The study was registered on ClinicalTrials.gov on March 19, 2018 (NCT03468868).</p>\",\"PeriodicalId\":9170,\"journal\":{\"name\":\"BMC Neurology\",\"volume\":\"24 1\",\"pages\":\"383\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-10-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465610/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12883-024-03871-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12883-024-03871-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Middle-range scores from the patient determined disease steps scale reflect varying levels of walking dysfunction in multiple sclerosis.
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 (F1,370 = 306.1, p < .0001, η2 = 0.48), T25FW (F1,370 = 161.0, p < .0001, η2 = 0.32), 6 MW (F1,370 = 178.9, p < .0001, η2 = 0.34), and MSWS-12 (F1,370 = 97.0, p < .0001, η2 = 0.24). There was a strong correlation between PDDS and EDSS scores (rs = 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).
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.
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