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Validity of minimal clinically important difference values for the multiple sclerosis walking scale-12?
Robert W Motl1, Yvonne C Learmonth, Lara A Pilutti
1Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Ill., USA.
Background And Objective:
Minimal clinically important difference (MCID) values of 4 and 6 points have been proposed for interpreting meaningful change in Multiple Sclerosis Walking Scale-12 (MSWS-12) scores. This study examined the validity of those MCID values based on capturing corresponding changes in other walking outcomes in persons with multiple sclerosis (MS).
Methods:
On 2 occasions separated by 6 months, 82 persons with MS completed the MSWS-12, timed 25-ft walk (T25FW), 6-min walk (6MW), and gait analysis, and then wore an accelerometer over a 7-day period. We generated change scores for the MSWS-12 and formed groups of stable, worsened, and improved perceived walking based on both 4- and 6-point changes. The groups were compared for corresponding changes in other walking measures over time using mixed-model ANOVAs.
Results:
The mixed-model ANOVAs did not identify statistically significant group-by-time interactions on the T25FW (p = 0.98 and p = 0.67), the 6MW (p = 0.89 and p = 0.72), gait (p = 0.54 and p = 0.21), or accelerometry (p = 0.40 and p = 0.68) for MCID values of 4- or 6-point changes in MSWS-12 scores.
Conclusions:
We did not confirm that MCID values of 4 and 6 points for the MSWS-12 correspond with changes in performance, gait, and free-living assessments of walking in MS.
Insights
Proposed minimal clinically important difference (MCID) values for the Multiple Sclerosis Walking Scale-12 (MSWS-12) were not validated. The study found no significant correlation between MSWS-12 score changes and other walking outcome improvements in individuals with multiple sclerosis (MS).
Area of Science:
- Neurology
- Rehabilitation Science
- Clinical Measurement
Background:
- Interpreting meaningful change in multiple sclerosis (MS) walking is crucial for patient care.
- Proposed minimal clinically important difference (MCID) values for the Multiple Sclerosis Walking Scale-12 (MSWS-12) are 4 and 6 points.
Purpose of the Study:
- To evaluate the validity of 4- and 6-point MCID values for the MSWS-12.
- To determine if MSWS-12 MCID values correspond with changes in objective walking measures in persons with MS.
Main Methods:
- 82 individuals with MS completed the MSWS-12, timed 25-ft walk (T25FW), 6-min walk (6MW), gait analysis, and wore an accelerometer over 7 days, twice over 6 months.
- Participants were grouped into stable, improved, or worsened perceived walking based on 4- or 6-point MSWS-12 changes.
- Mixed-model ANOVAs compared changes in walking outcomes across groups.
Main Results:
- No statistically significant group-by-time interactions were found for T25FW, 6MW, gait analysis, or accelerometry.
- This indicates that the proposed MCID values for the MSWS-12 did not align with significant changes in objective walking performance.
Conclusions:
- The study did not confirm that 4- or 6-point MCID values for the MSWS-12 reflect meaningful changes in walking.
- Further research is needed to establish reliable MCID values for assessing walking improvements in MS.
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