Telephone validation of an Urdu translated version of the extended disability severity scale in multiple sclerosis patients

In multiple sclerosis, the primary clinical measure of disability level is an ordinal score, the expanded disability severity scale score. In relapsing-remitting multiple sclerosis, measures of relapse are additionally of interest. Multiple sclerosis patients are typically assessed with regard to both the expanded disability severity scale and relapse state at each follow-up visit. As both are discrete measures, the two can be viewed as jointly dependent Markov processes. One of the main goals of multiple sclerosis research is to accurately model, over time, both transitions between expanded disability severity scale states and change in relapse state. This objective requires a number of significant modeling decisions, including decisions about whether or not the combination of specific disease states is warranted and assessment of the dependence structure between the two disease processes. Historically, such decisions are often made in an ad hoc manner and are not formally justified. We propose novel use of Bayes factors and Bayesian variable selection in the assessment of jointly dependent Markovian processes in multiple sclerosis. Methods are assessed using both simulated data and data collected from the Partners Multiple Sclerosis Center in Boston, MA.

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Cognitive strategies application of multiple sclerosis patients

Multiple Sclerosis Journal ◽

10.1191/1352458504ms980oa ◽

2004 ◽

Vol 10 (1) ◽

pp. 67-73 ◽

Cited By ~ 19

Author(s):

Smadar Birnboim ◽

Ariel Miller

Keyword(s):

Multiple Sclerosis ◽

Daily Living ◽

Cognitive Rehabilitation ◽

Cognitive Strategies ◽

Cognitive Disorders ◽

Cognitive Tests ◽

Severity Scale ◽

Life Tasks ◽

Multiple Sclerosis Patients ◽

Disability Severity

When performing a novel task, people need to generate and apply a working strategy. The applicatio n of an appro priate working strategy enables patients with cognitive impairment (C I) to perform tasks efficiently, which in turn makes it easier to meet the challenges of daily life tasks. We investigated the strategy application abilities (SAA) of multiple sclerosis (MS) patients and compared these results with data based on healthy subjects’ performance. Seventy-six patients performed a Strategy A pplication Test (SAT) along with other cognitive tests, and completed depression, fatigue, and activity of daily living (A DL) questionnaires. O ur results indicated that 76% of the MS patients included had impaired SAA, and that this impairment was not correlated with their depression, fatigue, Expanded Disability Severity Scale (EDSS), or A DL. These findings may have important implications for the understanding of the capability of MS patients to cope with nonroutine tasks, as well as for the potential of future implementation of cognitive rehabilitation in improving the SAA of patients with MS or other cognitive disorders.

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The Vibration Quantitation Scale (VQS): A Simple, Reproducible Bedside Measure of Sensory Function in Multiple Sclerosis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100003681 ◽

2004 ◽

Vol 31 (4) ◽

pp. 490-493

Author(s):

J. Carter ◽

T. Wasser ◽

S. Statler ◽

A.D. Rae-Grant

Keyword(s):

Multiple Sclerosis ◽

Tuning Fork ◽

Neurological Diseases ◽

Statistical Significance ◽

Sensory Function ◽

Strongly Correlated ◽

Sensory Abnormalities ◽

Multiple Sclerosis Patients ◽

Disability Severity ◽

Normal Controls

Objectives:To assess the utility of a bedside measure of sensation (the Vibration Quantitation Scale (VQS)) in patients with multiple sclerosis (MS) and in normal controls. To correlate the VQS with the Kurtzke Expanded Disability Severity Score (EDSS) and sensory abnormalities in these patients.Methods:We developed the VQS and tested its performance in patients with MS of various ages, MS types, and EDSS scores. We compared this with controls (normal volunteers or patients with other neurological diseases) who did not have sensory symptoms. In a subgroup, two examiners measured VQS independently at the same patient visit. Astandard C-128 tuning fork was used for the VQS measurement.Results:The VQS had a good inter-observer reproducibility (r=0.920, p<0.001). The VQS fell with increasing age in normals consistent with declining sensory function. The VQS was significantly lower in the multiple sclerosis patients compared with age - matched controls (p<0.001). Abnormalities in VQS were present in patients with brief duration of MS (<5 years) and low EDSS scores, correlating with the presence of sensory abnormalities early in the disease course in some patients. There was a strong correlation between the VQS and EDSS (r=-0.509). The VQS correlated with abnormal sensation in the hands (r=0.310), but did not meet statistical significance for abnormal sensation in the feet or face. Asecond cohort of MS patients was studied using a modified VQS measure (single stimulation, omitting forehead measurement). This reconfirmed the correlation between the modified VQS and EDSS as well as with age. The modified VQS may be useful in clinical practice since it takes little time and is strongly correlated with the EDSS (r=0.578).Conclusion:The VQS provides a continuous sensory scale applicable in most patients with MS, which is measurable with standard bedside equipment, and which may avoid some of the pitfalls of sensory scoring in MS.

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Validity and reliability of the Fatigue Severity Scale in Finnish multiple sclerosis patients

Brain and Behavior ◽

10.1002/brb3.743 ◽

2017 ◽

Vol 7 (7) ◽

pp. e00743 ◽

Cited By ~ 19

Author(s):

Eija Rosti-Otajärvi ◽

Päivi Hämäläinen ◽

Anna Wiksten ◽

Tanja Hakkarainen ◽

Juhani Ruutiainen

Keyword(s):

Multiple Sclerosis ◽

Fatigue Severity Scale ◽

Severity Scale ◽

Validity And Reliability ◽

Fatigue Severity ◽

Multiple Sclerosis Patients

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Correlation of self-assessed fatigue and alertness in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458510374202 ◽

2010 ◽

Vol 16 (9) ◽

pp. 1134-1140 ◽

Cited By ~ 62

Author(s):

Nicholetta Weinges-Evers ◽

Alexander U Brandt ◽

Markus Bock ◽

Caspar F Pfueller ◽

Jan Dörr ◽

...

Keyword(s):

Multiple Sclerosis ◽

Neuropsychological Tests ◽

Fatigue Severity Scale ◽

Expanded Disability Status Scale ◽

Severity Scale ◽

Disability Status ◽

Attentional Performance ◽

Fatigue Severity ◽

Repeatable Battery ◽

Multiple Sclerosis Patients

Background: Fatigue is the most common symptom in multiple sclerosis patients, but is difficult to measure; quantification thus relies on self-assessed questionnaires. Objective: To evaluate a battery of neuropsychological tests regarding their capacity to objectify self-reported fatigue. Methods: We assessed the correlation between age, gender, education, Kurtzke’s Expanded Disability Status Scale, depression, fatigue and neuropsychological testing using a cross-sectional approach in 110 multiple sclerosis patients. Fatigue was measured with the Fatigue Severity Scale. Cognition was measured using a series of neuropsychological tests including three subtests of the Test of Attentional Performance, the Brief Repeatable Battery of Neuropsychological Tests and the Faces Symbol Test. Results: According to the Fatigue Severity Scale 51.4% of the cohort were fatigued (scores ≥4). Age, education and depression showed a significant correlation with the Fatigue Severity Scale. Only 5.5% of the cohort exhibited cognitive impairment in the Brief Repeatable Battery of Neuropsychological Tests scores. After correction for age, education, Expanded Disability Status Scale and depression, Fatigue Severity Scale scores were an independent predictor of performance in the alertness subtest of the Test of Attentional Performance (standardized coefficient beta = 0.298, p = 0.014). Conclusion: The alertness subtest of the Test of Attentional Performance may offer an objective method of evaluating self-reported fatigue, and may therefore — in addition to the Fatigue Severity Scale — be a suitable tool for the assessment of multiple sclerosis patients complaining of fatigue.

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The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients

International Journal of Rehabilitation Research ◽

10.1097/mrr.0b013e3280146ec4 ◽

2007 ◽

Vol 30 (1) ◽

pp. 81-85 ◽

Cited By ~ 81

Author(s):

Kadriye Armutlu ◽

Nilufer Cetisli Korkmaz ◽

Ilke Keser ◽

Vildan Sumbuloglu ◽

Derya Irem Akbiyik ◽

...

Keyword(s):

Multiple Sclerosis ◽

Fatigue Severity Scale ◽

Severity Scale ◽

Validity And Reliability ◽

Fatigue Severity ◽

Multiple Sclerosis Patients

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The effect of rehabilitation on the perceived level of fatigue of patients with multiple sclerosis

Physiotherapy ◽

10.1515/physio-2015-0015 ◽

2015 ◽

Vol 23 (3) ◽

Author(s):

Szymon Pasiut ◽

Katarzyna Juda ◽

Elżbieta Mirek ◽

Jadwiga Szymura

Keyword(s):

Multiple Sclerosis ◽

Chronic Fatigue ◽

Rehabilitation Programme ◽

Fatigue Severity Scale ◽

Subjective Feeling ◽

Severity Scale ◽

Predominant Symptom ◽

Number Of Patients ◽

Fatigue Severity ◽

Multiple Sclerosis Patients

AbstractFatigue is one of the three major symptoms affecting about 70-90% of multiple sclerosis patients (MS, ICD-10 G35), and a predominant symptom in nearly 50% of the patients. Fatigue is defined as a subjective feeling of lack of energy to start and continue an activity, which is not related to depression, or muscle weakening. There are similarities and differences between the fatigue experienced by healthy individuals, and the fatigue in multiple sclerosis patients. In both instances, fatigue becomes more intense as a result of stress, or physical and mental effort. Fatigue usually subsides after a rest, or a good night’s sleep. In MS patients, fatigue can be caused by even light physical, or mental exertion, and it takes longer than normal to go away. Rest, or sleep do not reduce its intensity.The main objective of the study was to assess the effect of a two-week rehabilitation programme on the perceived level of fatigue in multiple sclerosis patients.The study included 32 patients with clinically confirmed MS who underwent a comprehensive 2-week rehabilitation programme. The study was conducted at the “Ostoja” Centre for Multiple Sclerosis Patients in Wola Batorska from 15 July to 13 October 2013. It was based on a self-designed questionnaire which contained the basic patient data (age, sex), information on duration of the disease, type of MS the patient had been diagnosed with, as well as the Kurtzke Expanded Disability Status Scale, and the Fatigue Severity Scale. The respondents were assessed twice: on the first and last day of their stay in the Centre. The statistical analysis was carried out using the STATISTICA 10.0 software.The analysis revealed a statistically highly significant dependence between the two-week rehabilitation programme and the perceived level of fatigue. This means that the perceived level of fatigue in MS patients was significantly reduced as a result of the rehabilitation programme used.After the two-week rehabilitation programme, the perceived level of fatigue in MS patients significantly decreased. The two-week rehabilitation programme significantly reduced the number of patients suffering from chronic fatigue symptoms as assessed on the Fatigue Severity Scale.

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The measurement of ambulatory impairment in multiple sclerosis

Neurology ◽

10.1212/wnl.49.5.1419 ◽

1997 ◽

Vol 49 (5) ◽

pp. 1419-1424 ◽

Cited By ~ 72

Author(s):

S. R. Schwid ◽

A. D. Goodman ◽

D. H. Mattson ◽

C. Mihai ◽

K. M. Donohoe ◽

...

Keyword(s):

Multiple Sclerosis ◽

Therapeutic Effects ◽

Considerable Variability ◽

Severity Scale ◽

Precise Information ◽

Maximal Distance ◽

Ordinal Scales ◽

Edss Score ◽

Disability Severity ◽

Continuous Measures

The objective of this study was to examine the relationships between continuous measures of ambulatory impairment in MS patients and their ordinal counterparts. Much of the disability caused by MS is due to ambulatory impairment. The Expanded Disability Severity Scale (EDSS) and the Ambulation Index (AI) are ordinal measures of MS severity based largely on the maximal distance subjects can walk (Dmax) and the time to walk 8 m (T8), respectively. At EDSS levels 6.0 to 7.0 and AI levels 3 to 6, scores are defined more by the use of ambulatory aids, rather than by Dmax or T8. We determined Dmax (up to 500 m), T8, the EDSS score, and the AI in 237 ambulatory MS patients. The maximal distance subjects could walk and T8 were strongly related to their ordinal counterparts (Spearman r = 0.65 and 0.91, respectively), but the continuous measures showed considerable variability within EDSS and AI levels that the ordinal scales did not reflect. Most of the variability occurred at EDSS levels 6.0 to 7.0 and AI levels 3 to 6. Because the use of an aid did not clearly predict Dmax or T8, many patients in these ranges had better ambulatory function based on the continuous measures than those with less disability according to the ordinal scales. We found that Dmax and T8 provide more precise information about ambulatory impairment in MS than do the EDSS and AI, allowing better discrimination of differences between patients and potentially greater sensitivity to detect therapeutic effects in clinical trials.

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Treatment of Fatigue in Multiple Sclerosis Patients: A Neurocognitive Approach

Rehabilitation Research and Practice ◽

10.1155/2011/670537 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Mauro Catalan ◽

Alessandra De Michiel ◽

Alessio Bratina ◽

Susanna Mezzarobba ◽

Lorella Pellegrini ◽

...

Keyword(s):

Multiple Sclerosis ◽

Motor Planning ◽

Rehabilitation Program ◽

Severity Scale ◽

Impact Scale ◽

Disability Status ◽

Neurocognitive Rehabilitation ◽

Fatigue Severity ◽

Fatigue Impact Scale ◽

Multiple Sclerosis Patients

The objective of the study was to treat fatigue in patients with multiple sclerosis (MS) by a neurocognitive rehabilitation program aimed at improving motor planning by using motor imagery (MI). Twenty patients with clinically definite MS complaining of fatigue were treated for five weeks with exercises of neurocognitive rehabilitation twice a week. Patients were evaluated by Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), MSQoL54, Expanded Disability Status Scale (EDSS), and MS Functional Composite (MSFC). After treatment, a decrease in fatigue was detected with both FSS () and MFIS (). MSFC () and MSQoL54 () scores improved compared to baseline. At six-month followup, the improvement was confirmed for fatigue (FSS, ; MFIS ) and for the physical subscale of MSQoL54 (). No differences in disability scales were found. These results show that neurocognitive rehabilitation, based on MI, could be a strategy to treat fatigue in MS patients.

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