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Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
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Published on: June 30, 2014

Variations in functioning and disability in multiple sclerosis. A two-year prospective study.

Charlotte Ytterberg1, Sverker Johansson, Magnus Andersson

  • 1Division of Neurology R54, Dept. of Clinical Neuroscience, Karolinska University Hospital, Huddinge, 14186 Stockholm, Sweden. charlotte.ytterberg@ki.se

Journal of Neurology
|June 19, 2008
PubMed
Summary
This summary is machine-generated.

This study tracked functioning in 200 people with multiple sclerosis (MS) over two years. While most aspects varied, no overall decline was observed, highlighting the need for regular assessments in MS care.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Clinical Research

Background:

  • Multiple Sclerosis (MS) is a chronic neurological condition characterized by significant variability in patient functioning and disability.
  • Regular, multidimensional assessments are crucial for understanding the trajectory of MS and guiding interventions.
  • Previous research often focuses on specific deficits, potentially overlooking the dynamic nature of overall functioning in people with MS (PwMS).

Purpose of the Study:

  • To investigate longitudinal changes in various functional domains (cognition, dexterity, mobility, energy, mood, daily activities, social engagement) over two years in a cohort of PwMS.
  • To identify patterns of change and determine the clinical significance of score variations in different functional areas.
  • To emphasize the importance of systematic, regular, and multidimensional assessment in managing PwMS.

Main Methods:

  • A prospective study involving 200 PwMS attending an outpatient MS specialist clinic.
  • Data collected every six months over a 2-year period using standardized instruments: Symbol Digit Modalities Test, Nine Hole Peg Test, Timed 25 Foot Walk, Fatigue Severity Scale, Beck Depression Inventory, Katz ADL Index Extended, and Frenchay Activities Index.
  • Statistical analysis included repeated measures ANOVA for ratio data and Friedman ANOVA for ordinal data, alongside effect size calculations.

Main Results:

  • Significant variations were observed across nearly all studied functional domains, yet no general deterioration trend emerged in the sample.
  • The Frenchay Activities Index showed small effect sizes, while the Symbol Digit Modalities Test indicated a potential practice effect.
  • A clinically meaningful change (>20% score change) was demonstrated by 63% of participants in walking and 46% in manual dexterity.

Conclusions:

  • Functioning in PwMS is highly variable over time, necessitating regular, comprehensive assessments to capture these fluctuations.
  • Identified changes in mobility and dexterity suggest potential for meaningful clinical intervention.
  • Study findings underscore the need to consider functional variability and potential learning effects when designing MS research and interpreting results.