Article

Multiple sclerosis (MS) is a disease which has a variable clinical
presentation followed by a variable clinical course. Therefore, accuracy of
clinical rating scales to measure disability at initial clinical presentation and
during follow-up visits is essential to accurately capture the variability
inherent in this disease.
This is particularly vital when attempting to identify
the efficacy of interventions.
This observational study in veterans
with MS compared the Kurtkze Expanded Disability Status Scale (EDSS) and the
Total Functional Independence Measure (TFIM) scale as measures of MS-related
disability. METHODS: We retrospectively reviewed the electronic charts of 76
veterans with MS who are regularly followed in our VA MS clinic. Local
Institutional Review Board approval was obtained for the protocol. Data were
analyzed using SAS (SAS System for Windows, version 9.2, SAS Institute Inc.,
Cary, NC, USA). Chi-square and Fisher exact tests were used to assess categorical
variables. Kruskal-Wallis tests evaluated the relationships between MS types
[relapsing-remitting MS (RR), secondary progressive MS (SP), primary progressive
MS (PP) and clinical isolated syndrome (CIS)] and the initial TFIM, EDSS and
Impairment Index (II) scores. RESULTS: The EDSS score accurately measured
MS-related impairment at initial evaluation and follow-up relative to an II.
However, the EDSS score did not change over time, compared to the TFIM suggesting
reduced sensitivity of the EDSS for detecting change in MS-related disability
over time. CONCLUSIONS: This suggests TFIM scale is a more sensitive measure of
MS-related disability than EDSS for use in future MS clinical trials.
This study highlights that given the paucity of
scales to which EDSS has been compared, TFIM is a valuable adjunct to EDSS in
measuring MS-related disability. TFIM is able to accurately measure the severity
of MS-related disability and help provide for services patients with MS-related
disability would need. TFIM is an easy to administer and a sensitive scale to
measure the change in MS-related disability following interventions.

Langue : ANGLAIS