HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) The Bottom Line The Bottom Line Podcast All Versions of this Article: ptj.20070064v1 88/2/176    most recent Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Paltamaa, J. Articles by Mälkiä, E. Search for Related Content PubMed PubMed Citation Articles by Paltamaa, J. Articles by Mälkiä, E. Related Collections Multiple Sclerosis Disability Models Tests and Measurements Social Bookmarking                      What's this?

Measuring Deterioration in International Classification of Functioning Domains of People With Multiple Sclerosis Who Are Ambulatory

J Paltamaa, MSc, is Researcher and Physiotherapist, Department of Physical Medicine and Rehabilitation, Central Hospital, Jyväskylä, Finland, and a doctoral student in the Department of Health Sciences, University of Jyväskylä, PO Box 35 (Viv), FI-40014, Jyväskylä, Finland
T Sarasoja, MD, is Neurologist, Department of Neurology, Central Hospital, Jyväskylä, Finland
E Leskinen, PhD, is Professor in Statistics, Department of Mathematics and Statistics, University of Jyväskylä
J Wikström, MD, PhD, is Senior Lecturer, Department of Neurology, University of Helsinki, Finland
E Mälkiä, PhD, is Physiotherapist and Professor in Physiotherapy, Department of Health Sciences, University of Jyväskylä, Finland

Address all correspondence to Ms Paltamaa at: jaana.paltamaa{at}sport.jyu.fi

Background and Purpose: Measures to detect important effects related to physical therapy interventions must be able to detect an important change. The purpose of this study was to select the most responsive physical functioning measures for multiple sclerosis (MS) using the International Classification of Functioning, Disability and Health (ICF) as a framework.

Subjects: The participants were 120 people with MS who were ambulatory from a population-based sample.

Methods: Physical functioning was assessed by quantitative clinical measures of activities (n=5) and body functions (n=7) and by self-reported performance in self-care, mobility, and domestic life domains in the activities and participation component of the ICF at baseline and 2 years later. A participant's perception of change and a change in Expanded Disability Status Scale (EDSS) scores were used as external criteria in the analysis of the receiver operating characteristic curve and the minimally important change score. The minimal detectable change was calculated as distribution-based responsiveness.

Results: According to the external criteria, 51% of the participants showed deterioration as measured by their own perceptions compared with the 26% of the participants who showed deterioration as rated by the clinician. Regardless of the external criterion applied, the measures most responsive to deterioration were self-reported scores in self-care, mobility, and domestic life; distance walked and change in heart rate during a 6-minute walk test; 10-m walk test speeds, stride length, and cadence; repetitive squatting; and Box and Block Test scores.

Discussion and Conclusion: The results show the relative responsiveness of different measures in the subsample who deteriorated and provide data that can facilitate the interpretation of score changes in people with MS who are ambulatory for future studies and in clinical practice.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				A Giordano, E Pucci, P Naldi, L Mendozzi, C Milanese, F Tronci, M Leone, N Mascoli, L La Mantia, G Giuliani, et al. Responsiveness of patient reported outcome measures in multiple sclerosis relapses: the REMS study J. Neurol. Neurosurg. Psychiatry, September 1, 2009; 80(9): 1023 - 1028. [Abstract] [Full Text] [PDF]