Saturday, 2 May 2015

Walking changes over time

Motl RW, Putzki N, Pilutti LA, Cadavid D. Longitudinal Changes in Self-Reported Walking Ability in Multiple Sclerosis. PLoS One. 2015 May 1;10(5):e0125002. doi: 10.1371/journal.pone.0125002. eCollection 2015.

BACKGROUND: Patient-reported outcomes are increasingly used to understand the clinical meaningfulness of multiple sclerosis disability and its treatments. For example, the 12-item Multiple Sclerosis Walking Scale (MSWS-12) measures the patient-reported impact of the disease on walking ability.
OBJECTIVE: We studied longitudinal changes in walking ability using the MSWS-12 in a cohort of 108 patients with relapsing-remitting multiple sclerosis and moderate-to-severe disability from a single US centre cohort study investigating multiple sclerosis symptoms and physical activity.
METHODS: The MSWS-12 was completed every 6 months over 2 years together with self-reported measures of disease impact on daily life (Multiple Sclerosis Impact Scale) and walking disability (Patient Determined Disease Steps scale).
RESULTS: The results revealed a high frequency of self-reported changes in walking ability at the individual level, affecting approximately 80% of patients for all four time periods. MSWS-12 scores remained stable at the group level for all four time periods. The magnitude of observed changes at the individual level was higher than the proposed minimal clinically important differences of 4 or 6 points and correlated better with Multiple Sclerosis Impact Scale physical scores than psychological scores, but little with self-reported Patient Determined Disease Steps Scale scores.
CONCLUSIONS:This novel finding of frequent fluctuations in self-reported walking ability is new and requires further investigation.

I am sure you are aware of this aspect and it was evident from one of your comments as it relates to getting an EDSS measurement and how this may change. Most people did not change much over time. I am sure Google/Iphone can tell how much our smart phones move every day without the need for filling informs. What do think? 

4 comments:

  1. it must be brainfog but i didn't understand the conclusion: are people's walking ability changing faster or do they just think so but objectively they remain stable??

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    1. I think it is saying overall things are relatively stable but on a daily/weekly/monthly basis things can fluctuate

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  2. Isn't there a study going with FitBits? I feel like the variation by day might be surprising to observers since so much is an internal feeling about walking ability. ie: I might be observationally similar but outside observations don't capture energy expenditure.

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    1. I bet there is I wonder what study ProfG is doing with his? I think something that capures your activity over a longtimeis going to be more informative than looking at an artificial test once a year during a neurological examination

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