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Development of a gait module to complement the 12-item Multiple Sclerosis Walking Scale: a mixed methods study.

Sara Strzok1, Sophie Cleanthous1, Farrah Pompilus1

  • 1Modus Outcomes, Cambridge, USA and Letchworth, UK.

Multiple Sclerosis Journal - Experimental, Translational and Clinical
|August 10, 2018
PubMed
Summary

New gait items enhance the Multiple Sclerosis Walking Scale (MSWS-12) to better measure walking ability in higher-functioning patients. This addresses limitations in the current scale for multiple sclerosis (MS) treatment benefit assessment.

Keywords:
MSWS-12Rasch measurement theoryWalking abilitymultiple sclerosispatient-reported outcomes

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Psychometrics

Background:

  • The 12-item Multiple Sclerosis Walking Scale (MSWS-12) assesses walking ability in multiple sclerosis (MS) patients.
  • Previous analyses revealed floor and ceiling effects, limiting its use across the MS severity spectrum.
  • A need exists to refine measurement for higher-functioning MS populations.

Purpose of the Study:

  • To address floor effects in the MSWS-12.
  • To develop a gait module for improved measurement of treatment benefit in high-functioning MS patients.
  • To enhance the sensitivity of walking ability assessments.

Main Methods:

  • A mixed-methods design combining qualitative (interviews) and quantitative (Rasch Measurement Theory) approaches.
  • Involved relapsing-remitting MS patients and specialist neurologists.
  • Concept elicitation, cognitive debriefing, and psychometric analysis were employed.

Main Results:

  • Thirty-seven walking ability concepts were identified, forming a five-domain framework.
  • New gait items were developed, covering concepts like shuffling and tripping.
  • Rasch analysis confirmed improved measurement precision with MSWS-12 plus gait items.

Conclusions:

  • The addition of new gait items can enhance the sensitivity of the MSWS-12.
  • This improvement is particularly relevant for detecting clinical changes in higher-functioning MS patients.
  • Findings support better assessment of treatment benefits in this population.