Uwe M Pommerich1,2, John Brincks3, Anders Guldhammer Skjerbæk4, Ulrik Dalgas5. 1. Department of Public Health, Aarhus University, Aarhus, Denmark. uwepom@rm.dk. 2. Department of Clinical Medicine, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Voldbyvej 15, 8450, Hammel, Denmark. uwepom@rm.dk. 3. Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark. 4. MS Hospitals in Denmark, Ry, Denmark. 5. Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark.
Abstract
INTRODUCTION: The Six Spot Step Test has shown good psychometric properties in terms of validity and reliability in people with multiple sclerosis. Yet, the responsiveness and minimal important change are unknown. The objective was to investigate the responsiveness of the Six Spot Step Test against the perceived change of walking limitations and establish estimates for the minimal important change in people with multiple sclerosis. METHODS: The Six Spot Step Test was performed before and after four weeks of specialised multidisciplinary inpatient rehabilitation by 142 adults with mild to severe multiple sclerosis. Responsiveness was determined based on anchor- and distribution-based methods, using the Multiple Sclerosis Walking Scale-12 as external criterion. In a supplementary analysis, the Six-Minute Walking Test was used as an external criterion. RESULTS: The correlation between the baseline (r = 0.56, p < 0.01) and discharge (r = 0.55, p < 0.01) Multiple Sclerosis Walking Scale-12 and Six Spot Step Test scores were acceptable. Furthermore, the change scores were weakly associated (r = 0.1, p = 0.27). This trend was similar for the Six-Minute Walking Test when used as anchor. The smallest detectable change was estimated to 1.7 seconds. An improvement in the Six Spot Step Test exceeding 2.1 (95% CI - 0.9 to 5.0) sec and 4.9 (95% CI 1.2-8.6) sec may be considered clinically important on a group level based on the Multiple Sclerosis Walking Scale-12 and the Six-Minute Walking Test, respectively. CONCLUSION: In a sample of mild to severely disabled people with multiple sclerosis, the Six Spot Step Test showed fair responsiveness against a subjective and objective criterion, indicating a minimal important change between ≥ 2.1 and ≥ 4.9 seconds, respectively. However, a weak association between the change in the Six Spot Step Test and the subjective and objective external criterion calls for cautious interpretation. Hence, the results should be further verified against a valid external criterion.
INTRODUCTION: The Six Spot Step Test has shown good psychometric properties in terms of validity and reliability in people with multiple sclerosis. Yet, the responsiveness and minimal important change are unknown. The objective was to investigate the responsiveness of the Six Spot Step Test against the perceived change of walking limitations and establish estimates for the minimal important change in people with multiple sclerosis. METHODS: The Six Spot Step Test was performed before and after four weeks of specialised multidisciplinary inpatient rehabilitation by 142 adults with mild to severe multiple sclerosis. Responsiveness was determined based on anchor- and distribution-based methods, using the Multiple Sclerosis Walking Scale-12 as external criterion. In a supplementary analysis, the Six-Minute Walking Test was used as an external criterion. RESULTS: The correlation between the baseline (r = 0.56, p < 0.01) and discharge (r = 0.55, p < 0.01) Multiple Sclerosis Walking Scale-12 and Six Spot Step Test scores were acceptable. Furthermore, the change scores were weakly associated (r = 0.1, p = 0.27). This trend was similar for the Six-Minute Walking Test when used as anchor. The smallest detectable change was estimated to 1.7 seconds. An improvement in the Six Spot Step Test exceeding 2.1 (95% CI - 0.9 to 5.0) sec and 4.9 (95% CI 1.2-8.6) sec may be considered clinically important on a group level based on the Multiple Sclerosis Walking Scale-12 and the Six-Minute Walking Test, respectively. CONCLUSION: In a sample of mild to severely disabled people with multiple sclerosis, the Six Spot Step Test showed fair responsiveness against a subjective and objective criterion, indicating a minimal important change between ≥ 2.1 and ≥ 4.9 seconds, respectively. However, a weak association between the change in the Six Spot Step Test and the subjective and objective external criterion calls for cautious interpretation. Hence, the results should be further verified against a valid external criterion.
Authors: Melissa Kreutzfeldt; Henrik B Jensen; Mads Ravnborg; Lars H Markvardsen; Henning Andersen; Søren H Sindrup Journal: J Peripher Nerv Syst Date: 2017-06 Impact factor: 3.494
Authors: C Heesen; R Haase; S Melzig; J Poettgen; M Berghoff; F Paul; U Zettl; M Marziniak; K Angstwurm; R Kern; T Ziemssen; J P Stellmann Journal: Acta Neurol Scand Date: 2017-12-03 Impact factor: 3.209
Authors: Nora E Fritz; Rhul Evans R Marasigan; Peter A Calabresi; Scott D Newsome; Kathleen M Zackowski Journal: Neurorehabil Neural Repair Date: 2014-05-01 Impact factor: 3.919
Authors: Linard Filli; Tabea Sutter; Christopher S Easthope; Tim Killeen; Christian Meyer; Katja Reuter; Lilla Lörincz; Marc Bolliger; Michael Weller; Armin Curt; Dominik Straumann; Michael Linnebank; Björn Zörner Journal: Sci Rep Date: 2018-03-21 Impact factor: 4.379