Multidimensional Assessment of Tremor in Multiple Sclerosis

2010 ◽  
Vol 12 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Breanne Daudrich ◽  
Danielle Hurl ◽  
Susan Forwell
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Utility ◽  
Well Being ◽  
Criterion Validity ◽  
Assessment Instrument ◽  
Rater Reliability ◽  
Retest Reliability ◽  
Multidimensional Assessment ◽  
Test Retest Reliability ◽  
Study Participants

Tremor is a common symptom of multiple sclerosis (MS) that has debilitating effects on occupational performance and well-being. Tremor is complex, and a valid and reliable assessment tool that takes a multidimensional approach is needed to guide intervention decisions. A new assessment instrument, the Multidimensional Assessment of Tremor (MAT), was designed to measure the severity and functional impact of tremor in people with MS. This study was conducted to introduce this new tool and examine its reliability, validity, and clinical utility. Two clinicians tested the MAT and completed a questionnaire on its clinical utility. During an initial visit, 10 study participants with MS were administered the MAT, which was independently scored by two researchers to determine its inter-rater reliability. Four other tools commonly used to assess tremor were also administered to evaluate the MAT's criterion validity. During a second visit, the MAT was administered a second time to ascertain its test-retest reliability. Study participants demonstrated mild-to-severe tremor with marked functional difficulties. The MAT's inter-rater reliability and test-retest reliability were excellent, while its criterion validity ranged from poor to good. The clinicians, participants, and researchers found the clinical utility of the tool to be good. The MAT offers therapists a clinically useful, evidence-based, and multidimensional tool for evaluating tremor in MS.

scholarly journals Symbol Digit Modalities Test Variant in a Smartphone App for Persons With Multiple Sclerosis: Validation Study (Preprint)

2020 ◽  
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Marijn B Martens ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Construct Validity ◽  
Validation Study ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Smartphone App ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

BACKGROUND The decline of cognitive processing speed (CPS) is a common dysfunction in persons with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is widely used to formally quantify CPS. We implemented a variant of the SDMT in MS sherpa, a smartphone app for persons with MS. OBJECTIVE The aim of this study was to investigate the construct validity and test-retest reliability of the MS sherpa smartphone variant of the SDMT (sSDMT). METHODS We performed a validation study with 25 persons with relapsing-remitting MS and 79 healthy control (HC) subjects. In the HC group, 21 subjects were matched to the persons with MS with regard to age, gender, and education and they followed the same assessment schedule as the persons with MS (the “HC matched” group) and 58 subjects had a less intense assessment schedule to determine reference values (the “HC normative” group). Intraclass correlation coefficients (ICCs) were determined between the paper-and-pencil SDMT and its smartphone variant (sSDMT) on 2 occasions, 4 weeks apart. Other ICCs were determined for test-retest reliability, which were derived from 10 smartphone tests per study participant, with 3 days in between each test. Seven study participants with MS were interviewed regarding their experiences with the sSDMT. RESULTS The SDMT scores were on average 12.06% higher than the sSDMT scores, with a standard deviation of 10.68%. An ICC of 0.838 was found for the construct validity of the sSDMT in the combined analysis of persons with MS and HC subjects. Average ICCs for test-retest reliability of the sSDMT for persons with MS, the HC matched group, and the HC normative group were 0.874, 0.857, and 0.867, respectively. The practice effect was significant between the first and the second test of the persons with MS and the HC matched group and trivial for all other test-retests. The interviewed study participants expressed a positive attitude toward the sSDMT, but they also discussed the importance of adapting a smartphone cognition test in accordance with the needs of the individual persons with MS. CONCLUSIONS The high correlation between sSDMT and the conventional SDMT scores indicates a very good construct validity. Similarly, high correlations underpin a very good test-retest reliability of the sSDMT. We conclude that the sSDMT has the potential to be used as a tool to monitor CPS in persons with MS, both in clinical studies and in clinical practice.

scholarly journals A Two-Minute Walking Test With a Smartphone App for Persons With Multiple Sclerosis: Validation Study (Preprint)

2021 ◽  
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Frank Dorssers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Validation Study ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Walking Test ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

BACKGROUND Walking disturbances are a common dysfunction in persons with multiple sclerosis (MS). The 2-Minute Walking Test (2MWT) is widely used to quantify walking speed. We implemented a smartphone-based 2MWT (s2MWT) in MS sherpa, an app for persons with MS. When performing the s2MWT, users of the app are instructed to walk as fast as safely possible for 2 minutes in the open air, while the app records their movement and calculates the distance walked. OBJECTIVE The aim of this study is to investigate the concurrent validity and test-retest reliability of the MS sherpa s2MWT. METHODS We performed a validation study on 25 persons with relapsing-remitting MS and 79 healthy control (HC) participants. In the HC group, 21 participants were matched to the persons with MS based on age, gender, and education and these followed the same assessment schedule as the persons with MS (the <i>HC-matched</i> group), whereas 58 participants had a less intense assessment schedule to determine reference values (the <i>HC-normative</i> group). Intraclass correlation coefficients (ICCs) were determined between the distance measured by the s2MWT and the distance measured using distance markers on the pavement during these s2MWT assessments. ICCs were also determined for test-retest reliability and derived from 10 smartphone tests per study participant, with 3 days in between each test. We interviewed 7 study participants with MS regarding their experiences with the s2MWT. RESULTS In total, 755 s2MWTs were completed. The adherence rate for the persons with MS and the participants in the HC-matched group was 92.4% (425/460). The calculated distance walked on the s2MWT was, on average, 8.43 m or 5% (SD 18.9 m or 11%) higher than the distance measured using distance markers (n=43). An ICC of 0.817 was found for the concurrent validity of the s2MWT in the combined analysis of persons with MS and HC participants. Average ICCs of 9 test-retest reliability analyses of the s2MWT for persons with MS and the participants in the HC-matched group were 0.648 (SD 0.150) and 0.600 (SD 0.090), respectively, whereas the average ICC of 2 test-retest reliability analyses of the s2MWT for the participants in the HC-normative group was 0.700 (SD 0.029). The interviewed study participants found the s2MWT easy to perform, but they also expressed that the test results can be confronting and that a pressure to reach a certain distance can be experienced. CONCLUSIONS The high correlation between s2MWT distance and the conventional 2MWT distance indicates a good concurrent validity. Similarly, high correlations underpin a good test-retest reliability of the s2MWT. We conclude that the s2MWT can be used to measure the distance that the persons with MS walk in 2 minutes outdoors near their home, from which both clinical studies and clinical practice can benefit.

scholarly journals A Two-Minute Walking Test With a Smartphone App for Persons With Multiple Sclerosis: Validation Study

10.2196/29128 ◽  
2021 ◽  
Vol 5 (11) ◽  
pp. e29128
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Frank Dorssers ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Validation Study ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Walking Test ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

Background Walking disturbances are a common dysfunction in persons with multiple sclerosis (MS). The 2-Minute Walking Test (2MWT) is widely used to quantify walking speed. We implemented a smartphone-based 2MWT (s2MWT) in MS sherpa, an app for persons with MS. When performing the s2MWT, users of the app are instructed to walk as fast as safely possible for 2 minutes in the open air, while the app records their movement and calculates the distance walked. Objective The aim of this study is to investigate the concurrent validity and test-retest reliability of the MS sherpa s2MWT. Methods We performed a validation study on 25 persons with relapsing-remitting MS and 79 healthy control (HC) participants. In the HC group, 21 participants were matched to the persons with MS based on age, gender, and education and these followed the same assessment schedule as the persons with MS (the HC-matched group), whereas 58 participants had a less intense assessment schedule to determine reference values (the HC-normative group). Intraclass correlation coefficients (ICCs) were determined between the distance measured by the s2MWT and the distance measured using distance markers on the pavement during these s2MWT assessments. ICCs were also determined for test-retest reliability and derived from 10 smartphone tests per study participant, with 3 days in between each test. We interviewed 7 study participants with MS regarding their experiences with the s2MWT. Results In total, 755 s2MWTs were completed. The adherence rate for the persons with MS and the participants in the HC-matched group was 92.4% (425/460). The calculated distance walked on the s2MWT was, on average, 8.43 m or 5% (SD 18.9 m or 11%) higher than the distance measured using distance markers (n=43). An ICC of 0.817 was found for the concurrent validity of the s2MWT in the combined analysis of persons with MS and HC participants. Average ICCs of 9 test-retest reliability analyses of the s2MWT for persons with MS and the participants in the HC-matched group were 0.648 (SD 0.150) and 0.600 (SD 0.090), respectively, whereas the average ICC of 2 test-retest reliability analyses of the s2MWT for the participants in the HC-normative group was 0.700 (SD 0.029). The interviewed study participants found the s2MWT easy to perform, but they also expressed that the test results can be confronting and that a pressure to reach a certain distance can be experienced. Conclusions The high correlation between s2MWT distance and the conventional 2MWT distance indicates a good concurrent validity. Similarly, high correlations underpin a good test-retest reliability of the s2MWT. We conclude that the s2MWT can be used to measure the distance that the persons with MS walk in 2 minutes outdoors near their home, from which both clinical studies and clinical practice can benefit.

scholarly journals Symbol Digit Modalities Test Variant in a Smartphone App for Persons With Multiple Sclerosis: Validation Study

10.2196/18160 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e18160
Author(s):  
Pim van Oirschot ◽  
Marco Heerings ◽  
Karine Wendrich ◽  
Bram den Teuling ◽  
Marijn B Martens ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Construct Validity ◽  
Validation Study ◽  
Intraclass Correlation ◽  
Study Participant ◽  
Smartphone App ◽  
Retest Reliability ◽  
Matched Group ◽  
Test Retest Reliability ◽  
Study Participants

Background The decline of cognitive processing speed (CPS) is a common dysfunction in persons with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is widely used to formally quantify CPS. We implemented a variant of the SDMT in MS sherpa, a smartphone app for persons with MS. Objective The aim of this study was to investigate the construct validity and test-retest reliability of the MS sherpa smartphone variant of the SDMT (sSDMT). Methods We performed a validation study with 25 persons with relapsing-remitting MS and 79 healthy control (HC) subjects. In the HC group, 21 subjects were matched to the persons with MS with regard to age, gender, and education and they followed the same assessment schedule as the persons with MS (the “HC matched” group) and 58 subjects had a less intense assessment schedule to determine reference values (the “HC normative” group). Intraclass correlation coefficients (ICCs) were determined between the paper-and-pencil SDMT and its smartphone variant (sSDMT) on 2 occasions, 4 weeks apart. Other ICCs were determined for test-retest reliability, which were derived from 10 smartphone tests per study participant, with 3 days in between each test. Seven study participants with MS were interviewed regarding their experiences with the sSDMT. Results The SDMT scores were on average 12.06% higher than the sSDMT scores, with a standard deviation of 10.68%. An ICC of 0.838 was found for the construct validity of the sSDMT in the combined analysis of persons with MS and HC subjects. Average ICCs for test-retest reliability of the sSDMT for persons with MS, the HC matched group, and the HC normative group were 0.874, 0.857, and 0.867, respectively. The practice effect was significant between the first and the second test of the persons with MS and the HC matched group and trivial for all other test-retests. The interviewed study participants expressed a positive attitude toward the sSDMT, but they also discussed the importance of adapting a smartphone cognition test in accordance with the needs of the individual persons with MS. Conclusions The high correlation between sSDMT and the conventional SDMT scores indicates a very good construct validity. Similarly, high correlations underpin a very good test-retest reliability of the sSDMT. We conclude that the sSDMT has the potential to be used as a tool to monitor CPS in persons with MS, both in clinical studies and in clinical practice.

Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in the Russian Population

2021 ◽  
pp. 1-8
Author(s):  
Evgeniy Evdoshenko ◽  
Kristina Laskova ◽  
Maria Shumilina ◽  
Ekaterina Nekrashevich ◽  
Maria Andreeva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Assessment ◽  
Verbal Learning ◽  
Cognitive Status ◽  
Russian Population ◽  
Cognitive Domain ◽  
Control Group ◽  
Retest Reliability ◽  
Valid Instrument ◽  
Test Retest Reliability

Abstract Objective: Cognitive dysfunction is common in multiple sclerosis (MS). The Brief International Cognitive Assessment for MS (BICAMS) battery of tests has been suggested as a measure for the evaluation of the cognitive status of MS patients. This study aims to validate the BICAMS battery in the Russian population of MS patients. Methods: Age- and sex-matched MS patients (n = 98) and healthy individuals (n = 86) were included in the study. Symbol Digit Modalities Test (SDMT), California Verbal Learning Test, 2nd edition (CVLT-II) and the Brief Visuospatial Memory Test – Revised (BVMT-R) were administered to all participants. The battery was readministered 1 month later to 44 MS patients to investigate the test–retest reliability. Results: MS patients exhibited a significantly lower performance in testing with BICAMS than the control group in all three neuropsychological tests. Test–retest reliability was good for SDMT and CVLT-II (r = .82 and r = .85, respectively) and adequate for BVMT-R (r = .70). Based on the proposed criterion for impairment as z score below 1.5 SD the mean of the control group, we found that 34/98 (35%) of MS patients were found impaired at least in one cognitive domain. Patients with Expanded Disability Status Scale score ≥3.5 performed significantly worse than controls (SDMT, p < .0001; CVLT–II, p = .03; BVMT-R, p = .0004), while those with ≤3.0 scores did not. Conclusion: This study demonstrates that the BICAMS battery is a valid instrument to identify cognitive impairment in MS patients and it can be recommended for routine use in the Russian Federation.

scholarly journals The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): Validation in Arabic and Lebanese Normative Values

2021 ◽  
pp. 1-10
Author(s):  
Hala Darwish ◽  
Pia Zeinoun ◽  
Natali Farran ◽  
Husam Ghusn ◽  
Bassem Yamout ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Healthy Subjects ◽  
Good Evidence ◽  
Normative Values ◽  
Arabic Version ◽  
Retest Reliability ◽  
Test Retest Reliability ◽  
Healthy Participants

Abstract Objective: Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients’ cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. Method: The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2–3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test–retest reliability and criterion-related validity were examined, and regression-based norms were derived. Results: The test–retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. Conclusions: This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT’s reliability was shown in the healthy participants, less test–retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.

Test–Retest Reliability of the Mini-BESTest in People With Mild to Moderate Multiple Sclerosis

2021 ◽  
Author(s):  
A Wallin ◽  
M Kierkegaard ◽  
E Franzén ◽  
S Johansson
Keyword(s):  
Multiple Sclerosis ◽  
Measurement Errors ◽  
Balance Control ◽  
Intraclass Correlation ◽  
Repeated Measurements ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Limits Of Agreement ◽  
Retest Reliability ◽  
Test Retest Reliability

Abstract Objective The mini-BESTest is a balance measure for assessment of the underlying physiological systems for balance control in adults. Evaluations of test–retest reliability of the mini-BESTest in larger samples of people with multiple sclerosis (MS) are lacking. The purpose of this study was to investigate test–retest reliability of the mini-BESTest total and section sum scores and individual items in people with mild to moderate overall MS disability. Methods This study used a test–retest design in a movement laboratory setting. Fifty-four people with mild to moderate overall MS disability according to the Expanded Disability Status scale (EDSS) were included, with 28 in the mild subgroup (EDSS 2.0–3.5) and 26 in the moderate subgroup (EDSS 4.0–5.5). Test–retest reliability of the mini-BESTest was evaluated by repeated measurements taken 1 week apart. Reliability and measurement error were analyzed. Results Test–retest reliability for the total scores were considered good to excellent, with intraclass correlation coefficients of .88 for the whole sample, .83 for the mild MS subgroup, and .80 for the moderate MS subgroup. Measurement errors were small, with standard error of measurement and minimal detectable change of 1.3 and 3.5, respectively, in mild MS, and 1.7 and 4.7, respectively, in moderate MS. The limits of agreement were − 3.4 and 4.6. Test–retest reliability for the section scores were fair to good or excellent; weighted kappa values ranged from .62 to .83. All items but 1 showed fair to good or excellent test–retest reliability, and percentage agreement ranged from 61% to 100%. Conclusions The mini-BESTest demonstrated good to excellent test–retest reliability and small measurement errors and is recommended for use in people with mild to moderate MS. Impact Knowledge of limits of agreement and minimal detectable change contribute to interpretability of the mini-BESTest total score. The findings of this study enhance the clinical usefulness of the test for evaluation of balance control and for designing individually customized balance training with high precision and accuracy in people with MS.

Perceived Causal Problem Networks: Reliability, Central Problems, and Clinical Utility for Depression

Assessment ◽  
2021 ◽  
pp. 107319112110392
Author(s):  
Lars Klintwall ◽  
Martin Bellander ◽  
Matti Cervin
Keyword(s):  
Clinical Utility ◽  
Treatment Success ◽  
Centrality Measures ◽  
Retest Reliability ◽  
Causal Relations ◽  
Future Studies ◽  
Causal Networks ◽  
Novel Method ◽  
The Individual ◽  
Test Retest Reliability

Personalized case conceptualization is often regarded as a prerequisite for treatment success in psychotherapy for patients with comorbidity. This article presents Perceived Causal Networks, a novel method in which patients rate perceived causal relations among behavioral and emotional problems. First, 231 respondents screening positive for depression completed an online Perceived Causal Networks questionnaire. Median completion time (including repeat items to assess immediate test–retest reliability) was 22.7 minutes, and centrality measures showed excellent immediate test–retest reliability. Networks were highly idiosyncratic, but worrying and ruminating were the most central items for a third of respondents. Second, 50 psychotherapists rated the clinical utility of Perceived Causal Networks visualizations. Ninety-six percent rated the networks as clinically useful, and the information in the individual visualizations was judged to contain 47% of the information typically collected during a psychotherapy assessment phase. Future studies should individualize networks further and evaluate the validity of perceived causal relations.

scholarly journals Psychometric properties of gross motor assessment tools for children: a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021734 ◽  
Author(s):  
Alison Griffiths ◽  
Rachel Toovey ◽  
Prue E Morgan ◽  
Alicia J Spittle
Keyword(s):  
Psychometric Properties ◽  
Predictive Validity ◽  
Methodological Quality ◽  
Clinical Utility ◽  
Assessment Tools ◽  
Motor Assessment ◽  
Gross Motor ◽  
Retest Reliability ◽  
Validity Test ◽  
Test Retest Reliability

ObjectiveGross motor assessment tools have a critical role in identifying, diagnosing and evaluating motor difficulties in childhood. The objective of this review was to systematically evaluate the psychometric properties and clinical utility of gross motor assessment tools for children aged 2–12 years.MethodA systematic search of MEDLINE, Embase, CINAHL and AMED was performed between May and July 2017. Methodological quality was assessed with the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and an outcome measures rating form was used to evaluate reliability, validity and clinical utility of assessment tools.ResultsSeven assessment tools from 37 studies/manuals met the inclusion criteria: Bayley Scale of Infant and Toddler Development-III (Bayley-III), Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2), Movement Assessment Battery for Children-2 (MABC-2), McCarron Assessment of Neuromuscular Development (MAND), Neurological Sensory Motor Developmental Assessment (NSMDA), Peabody Developmental Motor Scales-2 (PDMS-2) and Test of Gross Motor Development-2 (TGMD-2). Methodological quality varied from poor to excellent. Validity and internal consistency varied from fair to excellent (α=0.5–0.99). The Bayley-III, NSMDA and MABC-2 have evidence of predictive validity. Test–retest reliability is excellent in the BOT-2 (intraclass correlation coefficient (ICC)=0.80–0.99), PDMS-2 (ICC=0.97), MABC-2 (ICC=0.83–0.96) and TGMD-2 (ICC=0.81–0.92). TGMD-2 has the highest inter-rater (ICC=0.88–0.93) and intrarater reliability (ICC=0.92–0.99).ConclusionsThe majority of gross motor assessments for children have good-excellent validity. Test–retest reliability is highest in the BOT-2, MABC-2, PDMS-2 and TGMD-2. The Bayley-III has the best predictive validity at 2 years of age for later motor outcome. None of the assessment tools demonstrate good evaluative validity. Further research on evaluative gross motor assessment tools are urgently needed.

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