Responsiveness and clinically meaningful improvement, according to disability level, of walking measures after rehabilitation in multiple sclerosis: a European multi-center study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F14%3AN0000031" target="_blank" >RIV/00064173:_____/14:N0000031 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1177/1545968314521010" target="_blank" >http://dx.doi.org/10.1177/1545968314521010</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1177/1545968314521010" target="_blank" >10.1177/1545968314521010</a>

Result language

angličtina

Original language name

Responsiveness and clinically meaningful improvement, according to disability level, of walking measures after rehabilitation in multiple sclerosis: a European multi-center study

Original language description

Background. Evaluation of treatment effects on walking requires appropriate and responsive outcome measures. Objectives. To determine responsiveness of 5 walking measures and provide reference values for clinically meaningful improvements, according to disability level, in persons with multiple sclerosis (pwMS). Methods. Walking tests were measured pre- and postrehabilitation in 290 pwMS from 17 European centers. Combined anchor- and distribution-based methods determined responsiveness of objective short and long walking capacity tests (Timed 25-Foot Walk [T25FW] and 2- and 6-Minute Walk Tests [2MWT and 6MWT] and of the patient-reported Multiple Sclerosis Walking Scale-12 [MSWS-12]). A global rating of change scale, from patients' and therapists' perspective, was used as external criteria to determine the area under the receiver operating characteristic curve (AUC), minimally important change (MIC), and smallest real change (SRC). Patients were stratified into disability subgroups (Expanded Disability Status Scale score LESS-THAN OR EQUAL TO4 [n = 98], >4 [n = 186]). Results. MSWS-12, 2MWT, and 6MWT were more responsive (AUC 0.64-0.73) than T25FW (0.50-0.63), especially in moderate to severely disabled pwMS. Clinically meaningful changes (MICs) from patient and therapist perspective were MINUS SIGN 10.4 and MINUS SIGN 11.4 for MSWS-12 (P < .01), 9.6 m and 6.8 m for 2MWT (P < .05), and 21.6 m (P < .05) and 9.1 m (P = .3) for 6MWT. In subgroups, MIC was significant from patient perspective for 2MWT (10.8 m) and from therapist perspective for MSWS-12 (MINUS SIGN 10.7) in mildly disabled pwMS. In moderate to severely disabled pwMS, MIC was significant for MSWS-12 (MINUS SIGN 14.1 and MINUS SIGN 11.9). Conclusions. Long walking tests and patient-reported MSWS-12 were more appropriate than short walking tests in detecting clinically meaningful improvement after physical rehabilitation, particularly the MSWS-12 for moderate to severely disabled pwMS.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FP - Other medical fields

OECD FORD branch

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Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2014

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Neurorehabilitation and Neural Repair

ISSN

1545-9683

e-ISSN

—

Volume of the periodical

28

Issue of the periodical within the volume

7

Country of publishing house

US - UNITED STATES

Number of pages

11

Pages from-to

621-631

UT code for WoS article

000340728100002

EID of the result in the Scopus database

2-s2.0-84906261642