The reliability, precision and clinically meaningful change of walking assessments in multiple sclerosis

Yvonne C. Learmonth, Deirdre D. Dlugonski, Lara A. Pilutti, Brian M. Sandroff, Robert W. Motl

Research output: Contribution to journalArticlepeer-review

111 Scopus citations

Abstract

Background: Assessing walking impairment in those with multiple sclerosis (MS) is common, however little is known about the reliability, precision and clinically important change of walking outcomes. Objective: The purpose of this study was to determine the reliability, precision and clinically important change of the Timed 25-Foot Walk (T25FW), Six-Minute Walk (6MW), Multiple Sclerosis Walking Scale-12 (MSWS-12) and accelerometry. Methods: Data were collected from 82 persons with MS at two time points, six months apart. Analyses were undertaken for the whole sample and stratified based on disability level and usage of walking aids. Intraclass correlation coefficient (ICC) analyses established reliability: standard error of measurement (SEM) and coefficient of variation (CV) determined precision; and minimal detectable change (MDC) defined clinically important change. Results: All outcome measures were reliable with precision and MDC varying between measures in the whole sample: T25FW: ICC=0.991; SEM=1 s; CV=6.2%; MDC=2.7 s (36%), 6MW: ICC=0.959; SEM=32 m; CV=6.2%; MDC=88 m (20%), MSWS-12: ICC=0.927; SEM=8; CV=27%; MDC=22 (53%), accelerometry counts/day: ICC=0.883; SEM=28450; CV=17%; MDC=78860 (52%), accelerometry steps/day: ICC=0.907; SEM=726; CV=16%; MDC=2011 (45%). Variation in these estimates was seen based on disability level and walking aid. Conclusion: The reliability of these outcomes is good and falls within acceptable ranges. Precision and clinically important change estimates provide guidelines for interpreting these outcomes in clinical and research settings.

Original languageEnglish
Pages (from-to)1784-1791
Number of pages8
JournalMultiple Sclerosis Journal
Volume19
Issue number13
DOIs
StatePublished - Nov 2013

Keywords

  • EDSS
  • Multiple sclerosis
  • clinical change
  • mobility
  • outcome measures
  • precision
  • reliability
  • walking

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'The reliability, precision and clinically meaningful change of walking assessments in multiple sclerosis'. Together they form a unique fingerprint.

Cite this