Ka-Hoo Lam1, Caspar E P van Munster1, Marcus D'Souza2, Saskia Steinheimer3, Christian P Kamm3,4, Jessica Burggraaff1, Matthew Johnson5, Yordan Zaykov5, Jonas Dorn6, Frank Dahlke6, Ludwig Kappos2, Joep Killestein1, Bernard Uitdehaag1. 1. Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands (CEPvM, K-HL, JB, JK, BU). 2. Neurologic Clinic and Polyclinic, Departments of Medicine, Biomedicine, and Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland (MD, LK). 3. Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland (SS, CPK). 4. Department of Neurology, Neurology and Neurorehabilitation Center, Luzerner Kantonsspital, Lucerne, Switzerland (CPK). 5. Microsoft Research UK, Cambridge, UK (MJ, YZ). 6. Novartis Pharma AG, Basel, Switzerland (JD, FD).
Abstract
BACKGROUND: Assessing motor functioning is important to monitor the disease course of multiple sclerosis (MS). Video-assisted rating of classic neurologic tests and activities of daily living may improve the detection of changes in motor functioning. We investigated the value of using video-assisted composite measures for the detection of changes in mobility and upper extremity function (UEF). METHODS: Forty-three patients with MS were recorded performing motor function tests before and during treatment with fampridine. Patients were classified as improved or not improved on mobility composite (MOB-COM) and UEF composite (UEF-COM) measures based on neurologists' ratings of the tests. The proportional agreements between the composite measures and the conventional measures-the Timed 25-Foot Walk test (T25FW) and the Nine-Hole Peg Test (NHPT)-were determined and compared with patient-perceived improvement, which was determined using patient-reported ratings of changes in mobility and UEF. RESULTS: Agreement between MOB-COM and T25FW was 79.5%, and agreement between UEF-COM and NHPT was 82.1%. Twenty-six of 39 patients (66.7%) reported mobility improvement; 6 of these reports were confirmed by both T25FW and MOB-COM, 4 were confirmed by T25FW only, and 2 were confirmed by MOB-COM only. For UEF, 13 of 39 patients (33.3%) reported improvement; 3 of these were confirmed by the NHPT and 3 were confirmed by the UEF-COM. CONCLUSIONS: Compared with the conventional NHPT measure, the video-assisted composite measure of UEF detected additional patient-perceived improvement. This was less evident for mobility measures. Video-assisted composite measures may enhance the detection of treatment effects in MS clinical practice and trials.
BACKGROUND: Assessing motor functioning is important to monitor the disease course of multiple sclerosis (MS). Video-assisted rating of classic neurologic tests and activities of daily living may improve the detection of changes in motor functioning. We investigated the value of using video-assisted composite measures for the detection of changes in mobility and upper extremity function (UEF). METHODS: Forty-three patients with MS were recorded performing motor function tests before and during treatment with fampridine. Patients were classified as improved or not improved on mobility composite (MOB-COM) and UEF composite (UEF-COM) measures based on neurologists' ratings of the tests. The proportional agreements between the composite measures and the conventional measures-the Timed 25-Foot Walk test (T25FW) and the Nine-Hole Peg Test (NHPT)-were determined and compared with patient-perceived improvement, which was determined using patient-reported ratings of changes in mobility and UEF. RESULTS: Agreement between MOB-COM and T25FW was 79.5%, and agreement between UEF-COM and NHPT was 82.1%. Twenty-six of 39 patients (66.7%) reported mobility improvement; 6 of these reports were confirmed by both T25FW and MOB-COM, 4 were confirmed by T25FW only, and 2 were confirmed by MOB-COM only. For UEF, 13 of 39 patients (33.3%) reported improvement; 3 of these were confirmed by the NHPT and 3 were confirmed by the UEF-COM. CONCLUSIONS: Compared with the conventional NHPT measure, the video-assisted composite measure of UEF detected additional patient-perceived improvement. This was less evident for mobility measures. Video-assisted composite measures may enhance the detection of treatment effects in MS clinical practice and trials.
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Authors: Caspar Ep van Munster; Marcus D'Souza; Saskia Steinheimer; Christian P Kamm; Jessica Burggraaff; Manuela Diederich; Kristina Kravalis; Jonas Dorn; Lorcan Walsh; Frank Dahlke; Ludwig Kappos; Bernard Mj Uitdehaag Journal: Mult Scler Date: 2018-08-31 Impact factor: 6.312