Improving Detection of Change in Motor Functioning in Multiple Sclerosis Using Video-Assisted Composite Measures.

Area of Science:

• Neurology
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Assessing motor functioning is crucial for monitoring multiple sclerosis (MS) progression.
• Video-assisted rating of neurological tests and daily activities may enhance detection of motor function changes.
• This study explores video-assisted composite measures for assessing mobility and upper extremity function (UEF) changes in MS.

Purpose of the Study:

• To evaluate the utility of video-assisted composite measures for detecting changes in mobility and upper extremity function (UEF) in multiple sclerosis (MS) patients.
• To compare the sensitivity of video-assisted composite measures against conventional tests and patient-reported outcomes.

Main Methods:

• Forty-three MS patients underwent motor function tests before and during fampridine treatment.
• Mobility composite (MOB-COM) and UEF composite (UEF-COM) measures were rated by neurologists.
• Agreements between composite measures (MOB-COM, UEF-COM) and conventional tests (Timed 25-Foot Walk Test [T25FW], Nine-Hole Peg Test [NHPT]) were assessed against patient-reported improvements.

Main Results:

• Agreement between MOB-COM and T25FW was 79.5%; between UEF-COM and NHPT was 82.1%.
• Of 39 patients reporting mobility improvement, 66.7% had their improvement confirmed by T25FW and/or MOB-COM.
• Of 39 patients reporting UEF improvement, 33.3% had their improvement confirmed by NHPT and/or UEF-COM.

Conclusions:

• Video-assisted UEF composite measures detected more patient-perceived improvements compared to the conventional Nine-Hole Peg Test.
• The enhanced detection of treatment effects was less pronounced for mobility measures.
• Video-assisted composite measures show potential for improving the detection of treatment effects in MS clinical trials and practice.