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Tuesday, November 11, 2014

A Better Way to Measure MS Disability?

Published: Nov 7, 2014 | Updated: Nov 9, 2014

By Parker Brown , Staff Writer, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Clinicians and researchers have been growing increasingly unhappy with standard measures of disability in multiple sclerosis patients. The most common, the Expanded Disability Status Scale (EDSS), is considered insensitive and emphasizes certain aspects of function over others that may be just as important for patients. Two presentations at the recent European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) annual meeting, held jointly this year with its North American counterpart, ACTRIMS, are examples of where the field may be headed.

Measuring Walk in MS, Cheaply and Efficiently

Researchers often rely on either visual inspection or motion capturing technology to determine how well a patient is walking. But the former is often inaccurate, and the latter can be expensive, said Jacob Sosnoff, PhD, of the University of Illinois in Urbana-Champaign, in a presentation at ECTRIMS-ACTRIMS.

Pressure sensitive walkways and motion tracking devices, however, can provide reliable and quantitative measures of ambulation in multiple sclerosis patients. Sosnoff and colleagues analyzed the walk of 86 ambulatory patients 6 months apart using GAITRite, a portable walkway sensitive to pressure. GAITRite -- whose products sell for $25,000 to $35,000 depending on the model, according to the company -- has previously been tested. In the current study, the researchers evaluated its reliability -- that is, whether results are similar in multiple tests during which the person's actual performance would not have changed substantially -- using intraclass correlation coefficients (ICC), which range from -1 to the perfectly correlated 1.

Five measures of walking were found to be reliable using the system:
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