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Updated: Oct 5, 2025
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
In multiple sclerosis, a Functional Independence Measure ≥ 107 is the best predictor of outcome after clean
Rebecca Haddad1, Philippe Lagnau2, Camille Chesnel2
1Sorbonne Universté, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France; Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
The Functional Independence Measure (FIM) best predicts successful clean intermittent catheterization training outcomes in multiple sclerosis patients compared to the Pencil and Paper Test (PP-Test). Both tools show similar sensitivity but FIM offers higher specificity for self-catheterization success.
Area of Science:
- Neuro-urology
- Rehabilitation medicine
- Clinical assessment tools
Background:
- Motor and cognitive assessments are crucial before clean intermittent catheterization (CIC) training.
- The Functional Independence Measure (FIM) and Pencil and Paper Test (PP-Test) are linked to self-catheterization learning in multiple sclerosis (MS).
Purpose of the Study:
- To compare the predictive performance of the FIM and PP-Test for CIC training outcomes in individuals with MS.
- To evaluate which validated instrument better predicts successful self-catheterization learning.
Main Methods:
- Retrospective study of 395 MS patients undergoing CIC training between 2011-2019.
- FIM and PP-Test administered pre-training; success defined as ≥2 self-catheterization trials post-training.
- Diagnostic performance analyzed using sensitivity, specificity, and AUC, with AUCs compared via DeLong test.
Main Results:
- 87% of patients successfully learned self-catheterization.
- Optimal FIM cut-off (≥107) yielded 73% sensitivity and 73% specificity; PP-Test cut-off (≥13) yielded 73% sensitivity and 63% specificity.
- FIM demonstrated a significantly higher AUC (0.79) than PP-Test (0.73, p=0.049), with large effect sizes for both (Cohen's d=1.14 for FIM, d=0.87 for PP-Test).
Conclusions:
- An FIM score of ≥107 is the most specific predictor for successful CIC training outcomes in MS.
- Both FIM and PP-Test exhibit comparable sensitivity and large effect sizes in predicting self-catheterization success.
- FIM shows superior predictive value, particularly in specificity, for CIC training in multiple sclerosis.
