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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
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Impairment and disability in persons with MS: do functional performance or functional limitations matter?

Rachel E Klaren1, Lara A Pilutti, Brian M Sandroff

  • 1a Department of Kinesiology & Community Health , University of Illinois , 233 Freer Hall, Urbana , IL 61801 , USA.

Psychology, Health & Medicine
|March 28, 2015
PubMed
Summary

Cardiorespiratory and muscular fitness impairments in multiple sclerosis (MS) are indirectly linked to disability through functional limitations, not functional performance. Exercise interventions targeting fitness may improve limitations in MS patients.

Keywords:
disabilityexercisefunctional limitationsfunctional performanceimpairmentmultiple sclerosis

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Area of Science:

  • Rehabilitation Medicine
  • Neurology
  • Exercise Physiology

Background:

  • Individuals with multiple sclerosis (MS) frequently experience cardiorespiratory and musculoskeletal impairments.
  • These impairments can impact functional performance, lead to functional limitations, and ultimately cause disability.
  • Nagi's disablement model provides a framework for understanding these relationships.

Purpose of the Study:

  • To examine the associations between cardiorespiratory fitness, muscular strength, functional performance, functional limitations, and disability limitations in persons with MS.
  • To investigate the pathways through which impairments influence disability using Nagi's disablement model.

Main Methods:

  • The study included 63 individuals with MS (relapsing-remitting MS, median EDSS 4.0, mean MS duration 13.1 years).
  • Measurements included aerobic fitness, muscular strength (impairment), functional performance, functional limitations, and disability limitations.
  • Path analysis was employed using Mplus 7.0 to analyze the data.

Main Results:

  • The final path analysis model demonstrated an excellent fit to the data.
  • Aerobic fitness and muscular strength were indirectly associated with disability limitations via functional limitations (indirect path coefficients of 0.29 and 0.20, respectively).
  • Neither aerobic fitness nor muscular strength showed a direct association with disability limitations through functional performance.

Conclusions:

  • Aerobic fitness and muscular strength are important targets for exercise interventions in multiple sclerosis.
  • Improving cardiorespiratory and muscular fitness may help reduce functional limitations and disability in individuals with MS.
  • Interventions should focus on enhancing fitness to mitigate the impact of MS on daily functioning.