Multiple Sclerosis
Table 1: General Tests Used for Assessment of Disability in Multiple Sclerosis Test Method
Type/Purpose (Assessor)
Expanded Questionnaire/general
Disability Status determination of disability Scale (EDSS)
status and disease progression (requires
a trained examiner, usually a neurologist).
practical methods measure walking ability, hand/eye motor function and cognitive function (trained examiner).
Details of Assessments Included
Rates patients on a scale of 0 (normal) to 10 (death due to MS) in 0.5 increments based on
increasing disability. Largely based on mobility (see Table 2).
Multiple Sclerosis Multidimensional tests/three A timed T25FW to measure leg Functional Composite (MSFC)
function/ambulation.
9HPT to measure arm/hand dexterity. PASAT to measure cognitive function.
Family Questionnaire-based/provides 59 questions in 6 subscales:
Assessment of overall assessment of disability mobility, symptoms, emotional MS Trial Outcome (trained examiner). Index (FAMS-TOI)
MS
Impairment Scale (MSIS)
Standard neurological examination/scale is a measure of accumulated
deficits assessed (neurologist, requires neurological diagnostic expertise).
wellbeing (depression), general contentment, thinking/fatigue and family/social wellbeing.
The MSIS score is the sum of 53 subscores (theoretical range of 0–204 points). Scores are drawn
Equipment Needed, Validity of Data, Time to Perform and Cost
Test form, pen. 15–30 minutes to complete. Minimal cost.
Stopwatch, pen,
test forms, peg test board, pegs. 20–30 minutes to complete. Low cost.
Test form, pen. 20–30 minutes to complete. Minimal cost.
Extended
questionnaire. >30 minutes
from assessments of accumulated to complete. neurological defects grouped into 7 types.
MS Self-Efficacy Questionnaire/two subscales 18 items on two subscales: the (MSSE)
with functional abilities, and the to complete. Minimal cost. Test form, pen.
measure function and control function scale measures confidence Few minutes (patient-completed questionnaire).
with ability to manage symptoms and to cope with the demands of illness.
MS Impact Scale-29 (MSIS-29)
88-item MS
Questionnaire (29 questions) in 20 questions on mobility and motor Test form, pen. two sections: physical and psychological impact (patient-completed questionnaire).
skills (MSIS-29-PHYS) and 9 questions Few minutes on illness, depression, state of mind, to complete. confidence (MSIS-29-PSYCH). Each question/item scores 0, 1, 2, 3 or 4.
Questionnaire/addresses
Spasticity Scale 8 areas (patient-completed (MSSS-88)
questionnaire, which can be mailed to patients).
Minimal cost. methods due to The 2 subscales are
unidimensional and show good internal consistency; not biased by the sex or age of patients.22 MS-specific.
88 questions in 8 subscales: muscle More time-consuming Reliable and valid, patient-based, stiffness, pain and discomfort, muscle than other test spasms, activities of daily living,
interval-level measure of the impact of spasticity in MS.2
walking, body movement, emotional number of questions. MS-specific. health, social functioning.
MS Severity Scale (MSSS)
Questionnaire/variation of Algorithm scores EDSS to the
EDSS method to take account distribution of disability in patients of disease duration (trained examiner).
Minimal cost except for investigator time interpreting data. Requires computer software algorithm
with comparable disease durations and EDSS forms. and creates a global MSSS figure.
Minimal cost.
A powerful method for comparing disease progression using single assessment data. The test is useful
for comparing groups of patients but it is not appropriate as a predictor of future disability in an individual due to fluctuation in parameters measured.14 MS-specific.
Scripps
Neurological Rating Scale
Health Utilities Index (HUI)
Questionnaire/summary measure of individual
22 parameters, mainly neurological Simple to perform. signs with one addressing gait trunk 10–20 minutes.
components of a neurological and balance. Scores: -10 (severe) to Minimal cost. examination for use in MS (trained examiner).
100 (normal).
Questionnaire/a general- purpose health assessment
population health studies (patient-completed questionnaire).
8 areas: vision, hearing, speech, ambulation, dexterity, emotion,
of 8 subscales (mark 3 version), cognition and pain. Each attribute describes health status for
consists of multiple levels.
Requires no equipment. 5 minutes.
Minimal cost.
Good coverage of neurological signs but assessment of walking and mobility limited to one parameter only.50,51
Provides detail on each attribute and captures combinations of deficits and summaries of HRQoL.21
control scale measures confidence Minimal cost.
Shows good internal consistency and reliability in the overall scale and the function and control subscales.49
Advantages/Disadvantages
Widely used test method, data valid but mobility assessments limited in scope.
Has poor psychometric properties and a modest inter-rater reliability; lacks linearity.10
Excellent test–retest reliability. Concurrent validity was
demonstrated by significant
correlations with the EDSS, SF-36 and the Sickness Impact Profile.16
Good internal consistency of the derived subscales, test–retest reliability, content, concurrent and construct validity.19,47
Studies show responsiveness of the MSIS is better than the EDSS for magnitude and stability over the range of measurement.48
62
EUROPEAN NEUROLOGICAL REVIEW
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116