Thursday, 14 August 2014

What increases your risk of waling worse

Miller DM, Thompson NR, Cohen JA, Fox RJ, Hartman J, Schwetz K, Conway DS, Rudick RA. Factors associated with clinically significant increased walking time in multiple sclerosis: Results of a survival analysis of short-term follow-up data from a clinical database. Mult Scler. 2014 Aug 11. pii: 1352458514544536. [Epub ahead of print]

BACKGROUND: Because multiple sclerosis (MS) is variable and unpredictable, if symptom worsening could be predicted, patients may feel better prepared to manage changes in function.
OBJECTIVE: The objective of this paper is to study the prediction of walking impairment in MS.
METHODS: We retrieved data for all MS patients at our centre (2008-2009), including baseline and follow-up timed 25-foot walk (T25FW) times. We assessed the incidence of ≥20% worsening in T25FW by developing two models: (1) disease course and (2) Multiple Sclerosis Performance Scales (MSPS) score. The outcome was days until ≥20% worsening in T25FW. 
RESULTS: Of 1544 patients, 309 (20%) experienced ≥20% worsening T25FW. For disease course, time to worsening was significantly shorter for secondary progressive vs. relapsing-remitting disease (p < 0.001). For MSPS, patients with lower baseline MSPS scores progressed more slowly (p = 0.001). In both models, sex, baseline T25W, and time since diagnosis were significantly associated with worsening. 
CONCLUSION: These findings suggest factors associated with worsening in T25FW and a potential approach to establishing indicators associated with clinically significant change.
So yet more data indicating that older people males and having more disability increases the risk of more problems with walking.

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