Anders Guldhammer Skjerbæk1, Finn Boesen1, Thor Petersen2, Peter Vestergaard Rasmussen2, Egon Stenager3, Michael Nørgaard1, Peter Feys4, Marie Louise Kjeldgaard-Jørgensen5, Lars Grøndahl Hvid5, Ulrik Dalgas5. 1. MS Hospitals in Denmark, Ry and Haslev, Denmark. 2. Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. 3. MS-Clinic of Southern Jutland (Sønderborg, Esbjerg, Kolding), Department of Neurology, Sønderborg, Denmark/Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark. 4. REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium. 5. Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark.
Abstract
BACKGROUND: In multiple sclerosis (MS), the Expanded Disability Status Scale (EDSS) reflects disease severity. Although parts of the EDSS are dependent on actual walking distance, self-reported statements are often applied. OBJECTIVES: The purpose of the present study was, therefore, to compare self-reported walking distance to actual walking distance to outline how this influences EDSS scoring. METHODS: MS patients with EDSS 4.0-7.5 (n = 273) were included from the Danish MS hospitals rehabilitation study (n = 427). All patients subjectively classified their maximal walking distance according to one of seven categories (>500; 300-499; 200-299; 100-199; 20-99; 5-19; 0-4 m). Subsequently, actual maximal walking distance was assessed and EDSS was determined from both self-reported walking distance (EDSSself-report) and actual walking distance (EDSSactual). RESULTS: In 145 patients (53%), self-reported walking distance was misclassified when compared to the actual walking distance. Misclassification was more frequent in patients using walking aids (64% vs. 44%, p < 0.05) and in patients with primary progressive MS (69%, p < 0.05). Misclassification of walking distance corresponded to incorrect EDSS scores (EDSSself-report vs EDSSactual) of ⩾0.5 point in 24%. CONCLUSION: In MS patients with EDSS 4.0-7.5, 53% misclassified their walking distance yielding incorrect EDSS scores in 24%. Therefore, correct EDSS determination must be based on measurement of actual walking distance.
BACKGROUND: In multiple sclerosis (MS), the Expanded Disability Status Scale (EDSS) reflects disease severity. Although parts of the EDSS are dependent on actual walking distance, self-reported statements are often applied. OBJECTIVES: The purpose of the present study was, therefore, to compare self-reported walking distance to actual walking distance to outline how this influences EDSS scoring. METHODS: MS patients with EDSS 4.0-7.5 (n = 273) were included from the Danish MS hospitals rehabilitation study (n = 427). All patients subjectively classified their maximal walking distance according to one of seven categories (>500; 300-499; 200-299; 100-199; 20-99; 5-19; 0-4 m). Subsequently, actual maximal walking distance was assessed and EDSS was determined from both self-reported walking distance (EDSSself-report) and actual walking distance (EDSSactual). RESULTS: In 145 patients (53%), self-reported walking distance was misclassified when compared to the actual walking distance. Misclassification was more frequent in patients using walking aids (64% vs. 44%, p < 0.05) and in patients with primary progressive MS (69%, p < 0.05). Misclassification of walking distance corresponded to incorrect EDSS scores (EDSSself-report vs EDSSactual) of ⩾0.5 point in 24%. CONCLUSION: In MS patients with EDSS 4.0-7.5, 53% misclassified their walking distance yielding incorrect EDSS scores in 24%. Therefore, correct EDSS determination must be based on measurement of actual walking distance.
Entities:
Keywords:
EDSS; Expanded Disability Status Scale; Outcome measurement; Walking; multiple sclerosis; primary progressive MS
Authors: Leif Er Simmatis; Albert Y Jin; Sean W Taylor; Etienne J Bisson; Stephen H Scott; Moogeh Baharnoori Journal: Mult Scler J Exp Transl Clin Date: 2020-10-15
Authors: Massimo Filippi; Maria Pia Amato; Diego Centonze; Paolo Gallo; Claudio Gasperini; Matilde Inglese; Francesco Patti; Carlo Pozzilli; Paolo Preziosa; Maria Trojano Journal: J Neurol Date: 2022-05-24 Impact factor: 6.682