Multiple sclerosis functional tests and their comparability with self-administered values: A pilot study
Abstract
Introduction. Neurological impairment in multiple sclerosis is highly variable among patients and over time it is difficult to quantify. The Multiple Sclerosis Outcome Assessment Consortium established sensitive, cost-effective, clinically significant, and reproducible measures of different functional systems to measure outcomes in clinical trials. However, their use in clinical care routines is not widespread due to time and training constraints.
Objective. To evaluate the self-administration feasibility of the timed 25-foot walking, symbol-digit-modality, and 9-peg hole tests in healthy individuals.
Materials and methods. We performed a descriptive pilot study. Healthy individuals between 18 and 80 years of age were included. The Timed 25-Foot Walking Test (T25-
FWT), the Symbol Digit Modality Test (SDMT), and the Nine-Hole Peg Test (9-HPT) (using the dominant and non-dominant hand) were administered by a trained physician, who also instructed the subjects about test self-administration. The correlation and agreement, between the guided and self-administered tests were assessed with Pearson and Spearman coefficients and the Bland-Altman method.
Results. Thirty-eight healthy volunteers were included. The median age was 36 (range: 23-55) years old, and 55.26% were female. The correlation coefficient between guided and selfadministered tests was 0.37 for the T25-FWT (p=0.01), 0.54 for the SDMT (p<0.001), and 0.64 and 0.65 for the 9-HPT, in the dominant and non-dominant hands, respectively (p<0,001). Both forms of administration were concordant for the T25-FWT (95%CI: -1,49 to 1,43), the 9-HPT with dominant hand (95%CI: -5,23 to 4,09), the 9-HPT with non-dominant hand (95%CI: -7,75 to 7,14) and the SDMT (95% CI: -20,94 to 24,10).
Conclusions. We provide a proof of concept related to the feasibility of the selfadministration of the T25-FWT, the 9-HPT, and the SDMT, as a tool to improve monitoring in routine clinical practice.
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References
Oh J, Vidal-Jordana A, Montalban X. Multiple sclerosis: clinical aspects. Curr Opin Neurol. 2018;31:752-9. https://doi.org/10.1097/WCO.0000000000000622
Coetzee T, Thompson AJ. Atlas of MS 2020: Informing global policy change. Mult Scler. 2020;26:1807-8. https://doi.org/10.1177/1352458520968
Walton C, King R, Rechtman L, Kaye W, Leray E, Marrie RA, et al. Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS, third edition. Mult Scler. 26;1816-21. https://doi.org/10.1177/1352458520970841
Jiménez C, Zarco L, Castañeda C, Otalora M, Martínez A, Rosselli D. Estado actual de la esclerosis múltiple en Colombia. Acta Neurol Colomb. 2015;31:385-90.
Goodin DS. The epidemiology of multiple sclerosis: Insights to disease pathogenesis. Handb Clin Neurol. 2014;122:231-66. https://doi.org/10.1016/B978-0-444-52001-2.00010-8
Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, et al. Defining the clinical course of multiple sclerosis: The 2013 revisions. Neurology. 2014;83:278-86. https://doi.org/10.1212/WNL.0000000000000560
Kappos L, Wolinsky JS, Giovannoni G, Arnold DL, Wang Q, Bernasconi C, et al. Contribution of relapse-independent progression vs relapse-associated worsening to overall confirmed disability accumulation in typical relapsing multiple sclerosis in a pooled analysis of two randomized clinical trials. JAMA Neurol. 2020;77:1132-40. https://doi.org/10.1001/JAMANEUROL.2020.1568
Kurtzke JF. A new scale for evaluating disability in multiple sclerosis. Neurology. 1983;33:1444-52. https://doi.org/10.1212/wnl.33.11.1444
Koch MW, Mostert JP, Wolinsky JS, Lublin FD, Uitdehaag B, Cutter GR. Comparison of the EDSS, timed 25-foot walk, and the 9-hole peg test as clinical trial outcomes in relapsingremitting multiple sclerosis. Neurology. 2021;97:1560-70. https://doi.org/10.1212/WNL.0000000000012690
Rudick RA, Larocca N, Hudson LD. Multiple Sclerosis Outcome Assessments Consortium: Genesis and initial project plan. Mult Scler. 2014;20:12-7. https://doi.org/10.1177/1352458513503392
Benedict RHB, Deluca J, Phillips G, LaRocca N, Hudson LD, Rudick R. Validity of the symbol digit modalities test as a cognition performance outcome measure for multiple sclerosis. Mult Scler. 2017;23:721-33. https://doi.org/10.1177/1352458517690821
Motl RW, Cohen JA, Benedict R, Phillips G, LaRocca N, Hudson LD, et al. Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis. Mult Scler. 2017;23:704-10. https://doi.org/10.1177/1352458517690823
Feys P, Lamers I, Francis G, Benedict R, Phillips G, Larocca N, et al. The nine-hole peg test as a manual dexterity performance measure for multiple sclerosis. Mult Scler. 2017;23:711-20. https://doi.org/10.1177/1352458517690824
Balcer LJ, Raynowska J, Nolan R, Galetta SL, Kapoor R, Benedict R, et al. Validity of lowcontrast letter acuity as a visual performance outcome measure for multiple sclerosis. Mult Scler. 2017;23:734-47. https://doi.org/10.1177/1352458517690822
Benedict RHB, Amato MP, Boringa J, Brochet B, Foley F, Fredrikson S, et al. Brief international cognitive assessment for MS (BICAMS): international standards for validation. BMC Neurol. 2012;12:55. https://doi.org/10.1186/1471-2377-12-55
Altman DG, Bland JM. Measurement in medicine: The analysis of method comparison studies. Statistician. 1983;32:307-17. https://doi.org/10.2307/2987937
Streiner DL, Norman GR, Cairney J. Oxford Medicine Online Health Measurement Scales: A practical guide to their development and use. Fith edition. Oxford: Oxford University Press; 2019. p. 1-27.
Harris PA, Taylor R, Minor BL, Elliott V, Fernández M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208. https://doi.org/10.1016/J.JBI.2019.103208
Symbol Digit Modalities Test (SDMT). Fecha de consulta: 15 de junio de 2020. Disponible en: https://www.wpspublish.com/sdmt-symbol-digit-modalities-test
Ryan J, Woods RL, Britt CJ, Murray AM, Shah RC, Reid CM, et al. Normative data for the symbol digit modalities test in older white Australians and Americans, African-Americans, and Hispanic/Latinos. J Alzheimers Dis Rep. 2020;4:313-23. https://doi.org/10.3233/ADR-200194
Sheridan LK, Fitzgerald HE, Adams KM, Nigg JT, Martel MM, Puttler LI, et al. Normative Symbol Digit Modalities Test performance in a community-based sample. Arch Clin Neuropsychol. 2006;21:23-8. https://doi.org/10.1016/J.ACN.2005.07.003
Arango-Lasprilla JC, Rivera D, Trapp S, Jiménez-Pérez C, Hernández-Carrillo CL, Pohlenz-Amador S, et al. Symbol Digit Modalities Test: Normative data for Spanish-speaking pediatric population. NeuroRehabilitation. 2017;41:639-47. https://doi.org/10.3233/NRE-172243
Kiely KM, Butterworth P, Watson N, Wooden M. The symbol digit modalities test: Normative data from a large nationally representative sample of Australians. Arch Clin Neuropsychol. 2014;29:767-75. https://doi.org/10.1093/ARCLIN/ACU055
Vanotti S, Cores EV, Eizaguirre B, Ángeles M, Rey R, Villa A, et al. Normatization of the symbol digit modalities test-oral version in a Latin American Country. Appl Neuropsychol. 2015;22:46-53. https://doi.org/10.1080/23279095.2013.831866
Nocentini U, Giordano A, Di Vincenzo S, Panella M, Pasqualetti P. The symbol digit modalities test - Oral version: Italian normative data. Funct Neurol. 2006;21:93-6.
Goldman MD, Motl RW, Scagnelli J, Pula JH, Sosnoff JJ, Cadavid D. Clinically meaningful performance benchmarks in MS: Timed 25-foot walk and the real world. Neurology. 2013;81:1856-63. https://doi.org/10.1212/01.WNL.0000436065.97642.D2
Oxford Grice K, Vogel KA, Le V, Mitchell A, Muniz S, Vollmer MA. Adult norms for a commercially available Nine Hole Peg Test for finger dexterity. Am J Occup Ther. 2003;5:570-3. https://doi.org/10.5014/ajot.57.5.570
Lindstrom-Hazel D, Aeyman U, Hossain SS, Nayan MJ, Chowdhury SK, Rector J, et al. A normative study of the nine-hole peg test in Bangladesh. Work. 2015;50:403-9. https://doi.org/10.3233/WOR-151996
Cadavid D, Cohen JA, Freedman MS, Goldman MD, Hartung HP, Havrdova E, et al. The EDSS-Plus, an improved endpoint for disability progression in secondary progressive multiple sclerosis. Multi Scler. 2017;23:94-105. https://doi.org/10.1177/1352458516638941
Alexander S, Peryer G, Gray E, Barkhof F, Chataway J. Wearable technologies to measure clinical outcomes in multiple sclerosis: A scoping review. Mult Scler. 2021;27:1643-56. https://doi.org/10.1177/1352458520946005
Maillart E, Labauge P, Cohen M, Maarouf A, Vukusic S, Donzé C, et al. MSCopilot, a new multiple sclerosis self-assessment digital solution: Results of a comparative study versus standard tests. Eur J Neurol. 2020;27:429-36. https://doi.org/10.1111/ENE.14091
van Oirschot P, Heerings M, Wendrich K, Den Teuling B, Martens MB, Jongen PJ. Symbol digit modalities test variant in a smartphone app for persons with multiple sclerosis: Validation study. JMIR Mhealth Uhealth. 2020;8:e18160. https://doi.org/10.2196/18160
Lam KH, van Oirschot P, den Teuling B, Hulst HE, de Jong BA, Uitdehaag BMJ, et al. Reliability, construct and concurrent validity of a smartphone-based cognition test in multiple sclerosis. Mult Scler. 2022;28:300-8. https://doi.org/10.1177/13524585211018103
Rao SM, Losinski G, Mourany L, Schindler D, Mamone B, Reece C, et al. Processing speed test: Validation of a self-administered, iPad®-based tool for screening cognitive dysfunction in a clinic setting. Mult Scler. 2017;23:1929-37. https://doi.org/10.1177/1352458516688955
Woelfle T, Pless S, Reyes O, Wiencierz A, Feinstein A, Calabrese P, et al. Reliability and acceptance of dreaMS, a software application for people with multiple sclerosis: A feasibility study. J Neurol. 2022;23:262-71. https://doi.org/10.1007/S00415-022-11306-5
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