Article

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
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 -10.4 and -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 (-10.7) in mildly disabled pwMS. In
moderate to severely disabled pwMS, MIC was significant for MSWS-12 (-14.1 and
-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.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS