What explains functioning from the perspective of people with multiple sclerosis?

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• The Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) aims to standardize the assessment of functioning in people with MS (pwMS).
• However, the optimal ICF categories for comprehensively capturing diverse functioning levels in pwMS require further validation.

Purpose of the Study:

• To determine if the existing Brief ICF Core Set for MS adequately represents the spectrum of functioning in pwMS.
• To identify specific ICF categories that best differentiate various levels of functioning in pwMS.

Main Methods:

• A multicenter, cross-sectional study involving 205 pwMS was conducted.
• Data were collected using the MS-specific WHO ICF Checklist and individual functioning ratings.
• Stepwise Ordinary Least-Squares regression analyses were employed to identify significant ICF categories.

Main Results:

• Eleven ICF categories were identified as highly effective in differentiating between different levels of functioning in pwMS.
• Of these eleven categories, only four are currently included in the Brief ICF Core Set for MS.
• This suggests a potential gap in the current Core Set's ability to fully capture functioning.

Conclusions:

• The identified eleven ICF categories offer a more refined approach to measuring functioning in pwMS.
• These categories can serve as valuable outcome measures for research, clinical monitoring across the lifespan, and for defining distinct patient subgroups.
• Revising the Brief ICF Core Set for MS may enhance its utility in clinical practice and research.