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Updated: Aug 11, 2026

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Health problems and health-related quality of life in people with multiple sclerosis
Angus Forbes1, Alison While, Lucia Mathes
1King's College London, The Florence Nightingale School of Nursing & Midwifery, Research in Primary and Intermediate Care Section, London, UK. angus.forbes@kcl.ac.uk
Objective:
To explore the interrelationship between a number of common multiple sclerosis-related problems and health-related quality of life independent of the effect of physical disease impact.
Design:
A cross-sectional postal survey.
Setting:
The study was conducted in seven treatment centres within England.
Subjects:
Nine hundred and twenty-nine people with multiple sclerosis.
Measures:
The severity of the multiple sclerosis problems (fatigue, pain, urinary incontinence, bowel, depression, pressure ulcers, sexual and employment problems) was assessed using 5-point self-report ordinal scales. Disease impact was measured using the Multiple Sclerosis Impact Scale-29. Health-related quality of life was measured using the 36-Item Short Form Health Survey, version 2 (SF-36). The relationship between the problems, disease impact and health-related quality of life was determined using multivariate analysis of covariance.
Results:
Seventy four per cent of the sample experienced four or more of the selected problems. The extent and severity of problems increased with the level of disease impact (P< 0.001). Fatigue, pain, employment, depression and relationship problems were all found to have negative effect on the SF-36 scales independent to the effect of disease impact. SF-36 scores were most compromised in patients experiencing multiple problems. The data suggest an interdependent relationship between depression, fatigue and pain.
Conclusion:
The data suggest that many multiple sclerosis complications negatively affect health-related quality of life, independent of the effect of overall disease impact.
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