Pilot Study of Smartphone-Based Neuroperformance Tests in Multiple Sclerosis

The Multiple Sclerosis Functional Composite and its iPad-based companion, the Multiple Sclerosis Performance Test (MSPT), as well as other traditional function tests must be performed during a clinic visit, which presents challenges for some people with multiple sclerosis (MS).

Smartphone tests were developed, including a remote Timed Up and Go (rTUG), remote 5 Times Sit-to-Stand (r5STS), finger tapping test (FTT), and processing speed test (PST), in addition to open- and closed-eye balance measures. People with MS and a control group (CG) without MS performed smartphone tests and the previously validated, iPad-based MSPT. Convergent validity, sensitivity to disease status, and test-retest reliability were assessed.

The CG (n = 23; mean age, 38.56 ± 18.5 years; 65% female; 74% White) and the MS group (n = 23; mean age, 58.5 ± 11.9 years; 48% female; 83% White; mean disease duration, 11.82 ± 6.72 years) completed tests at a single visit. Valid taps per second on FTT was moderately correlated with the manual dexterity test (Spearman correlation coefficients, ρ = -0.46 [right] and -0.41 [left]). Total number correct on smartphone-administered PST strongly correlated with iPad-administered PST (ρ = 0.78). rTUG had a strong correlation and r5STS had a moderate correlation with the Timed 25-Foot Walk test (ρ = 0.80 and 0.55, respectively). Ellipse volume and ellipse area, derived from open-eye balance tests, showed sensitivity to disease status (partial η2 = 0.08 and 0.07, respectively) and good test-retest reliability (intraclass correlation coefficient = 0.82 and 0.77, respectively).

The FTT, PST, rTUG, and r5STS performed via smartphone application demonstrate convergent validity with their analogous MSPT tests. Open-eye balance outcomes also show promise for use in people with MS. These smartphone-based tests may allow for remote measurement of function for people with MS.