Reliability and Minimal Detectable Change in the Gait Assessment and Intervention Tool in Patients With Multiple Sclerosis (original) (raw)
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Pm&r, 2020
Introduction. In clinical practice, observational scales are the most common approach used to assess gait pattern in people with neurological disorders. The Gait Assessment and Intervention Tool (GAIT) is an observational gait scale and it has proved to be the most comprehensive, homogeneous and objective of all the observational gait scales studied in people with neurological conditions. Objective. To study the construct validity of the GAIT in people with multiple sclerosis (MS). Design. An observational study was conducted. Setting. A Multiple Sclerosis Foundation in Madrid (Spain). Patients. 35 MS patients were assessed. Main Outcome Measure(s). GAIT construct validity was assessed using the following scales: Rivermead Visual Gait Assessment (RVGA), Tinetti Gait Scale (TGS), 10 Meter Walking Test (10mwt), Timed Up&Go (TUG), Hauser Ambulatory Index (HAI), Multiple Sclerosis Walking Scale-12 (MSWS-12), Functional Gait Assessment (FGA), Modified Ashworth Scale (MAS), and Rivermead Mobility Index (RMI).
Validity and Reliability of Four Clinical Gait Measures in Patients with Multiple Sclerosis
International journal of MS care, 2017
Background: The gold standards for assessing ambulation are the Expanded Disability Status Scale (EDSS) and the Timed 25-Foot Walk (T25FW) test. In relation with these measures, we assessed the reliability and validity of four clinical gait measures: the Timed Up and Go (TUG) test, the Dynamic Gait Index (DGI), the 2-Minute Walk Test (2MWT), and the 6-Minute Walk Test (6MWT). Patient self-report of gait was also assessed using the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Methods: Individuals 20 years or older with a diagnosis of multiple sclerosis (MS) and an EDSS score of 2.0 to 6.5 completed the MSWS-12, T25FW test, TUG test, DGI, 2MWT, and 6MWT. All the tests were repeated 2 weeks later at the same time of day to establish their reliability and concurrent validity. Predictive validity was established using the EDSS. Results: Forty-two patients with MS were included. All measures showed high test-retest reliability. The TUG test, 2MWT, and 6MWT were significantly correlated with the T25FW test (Spearman ρ = −0.902, −0.919, and −0.905, respectively). The EDSS was also significantly correlated with all the walking tests. The MSWS-12 demonstrated the highest correlation to the EDSS (ρ = 0.788). Conclusions: The TUG test, the DGI, the 2MWT, and the 6MWT exhibited strong psychometric properties and were found to be significant predictors of the EDSS score. Use of these tests to prospectively monitor the effects of medical and rehabilitation treatment should be considered in the comprehensive care of patients with MS.
Reliability of gait in multiple sclerosis over 6 months
Gait & Posture, 2015
Gait impairment is ubiquitous in multiple sclerosis (MS) and represents an outcome of interest for research and clinical practice . Gait can be indexed with various measures , and pressure sensitive walkways are feasible, valid and capable of detecting gait impairment across the spectrum of disability in person with MS who are ambulatory . Accordingly, pressure sensitive walkways could be incorporated into randomized control trials (RCTs) and clinical practice. Such uses require estimates regarding the reliability of parameters from pressure sensitive walkways for quantifying gait -especially over longer durations (e.g. 6 months) -that are consistent with periods of outcome assessment in clinical practice and research. Reliability is critical for informing clinical decision-making and power analyses for designing RCTs (i.e., sample size estimates). This paper provides reliability estimates for gait parameters (i.e., behavior, not the equipment) over 6 months in persons with MS in the absence of any additional intervention above and beyond usual care.
2018
Introduction: Dynamic Gait Index (DGI) has been used as a valid and reliable tool to assess balance performance in various populations. However, it has been translated into the Persian language and has shown perfect psychometric properties in the elderly population. The Persian version in Multiple Sclerosis (MS) population was validated, but its reliability has not been examined. The aim of the current study was to investigate the inter-rater reliability, test-retest reliability, and internal consistency of the Persian version of DGI in MS patients.Materials and Methods: A total of 62 participants took part in the reliability process. The sample included 51 females and 11 males. Inter-rater reliability was assessed by the agreement of the results obtained by two occupational therapists. We considered a 3-day interval for the first and second data collection. Test-retest and inter-rater reliability were measured with the Intraclass Correlation Coefficient (ICC2, 1) and internal consistency was evaluated with the Cronbach alpha.Results: The Persian version of DGI showed excellent inter-rater reliability (ICC for total score was 0.98 and ICC for the items ranged from 0.83 to 0.96) and test-retest reliability (ICC for the overall score was 0.97 and ICC for the items ranged from 0.82 to 0.96). The Cronbach alpha of the Persian version of DGI was 0.87.Conclusion: The Persian version of DGI can be used as a reliable tool for dynamic balance measurement of MS patients in clinical settings and research studies.
2018
Introduction: Dynamic Gait Index (DGI) has been used as a valid and reliable tool to assess balance performance in various populations. However, it has been translated into the Persian language and has shown perfect psychometric properties in the elderly population. The Persian version in Multiple Sclerosis (MS) population was validated, but its reliability has not been examined. The aim of the current study was to investigate the inter-rater reliability, test-retest reliability, and internal consistency of the Persian version of DGI in MS patients. Materials and Methods: A total of 62 participants took part in the reliability process. The sample included 51 females and 11 males. Inter-rater reliability was assessed by the agreement of the results obtained by two occupational therapists. We considered a 3-day interval for the first and second data collection. Test-retest and inter-rater reliability were measured with the Intraclass Correlation Coefficient (ICC2, 1) and internal consistency was evaluated with the Cronbach alpha. Results: The Persian version of DGI showed excellent inter-rater reliability (ICC for total score was 0.98 and ICC for the items ranged from 0.83 to 0.96) and test-retest reliability (ICC for the overall score was 0.97 and ICC for the items ranged from 0.82 to 0.96). The Cronbach alpha of the Persian version of DGI was 0.87. Conclusion: The Persian version of DGI can be used as a reliable tool for dynamic balance measurement of MS patients in clinical settings and research studies. Citation: Soltanpour H, Kalantari M, Roostaei M. Inter-rater Reliability, Test-retest Reliability, and Internal Consistency of the Persian Version of Dynamic Gait Index in Patients With Multiple Sclerosis. Journal of Modern Rehabilitation. 2018; 12(4):245-252. http://dx.
Journal of Neurology, 2022
The aim of this work was to determine whether wearable inertial measurement units (IMUs) could detect gait improvements across different disability groups of people with Multiple Sclerosis (pwMS) by the six-minute walk test (6MWT) during a rehabilitation stay in a specialized rehabilitation center. Forty-six pwMS and 20 healthy controls (HC) were included in the study. They performed the 6MWT with two inertial measurement units (IMUs) placed on the feet. Thirty-two of the pwMS were retested at the end of the stay. PwMS were divided in a mild-disability and a moderate-disability group. The 6MWT was divided in six sections of 1 min each for technical analysis, and linear mixed models were used for statistical analyses. The comparison between the two disability groups and HC highlighted significant differences for each gait parameter (all p < 0.001). The crossing effect between the test–retest and the two disability groups showed greater improvement for the moderate-disability group...
Neurology, 2018
Objective: Explore the relationship of MSWS-12, a patient-reported outcome (PRO) of walking ability in people with Multiple Sclerosis (PwMS), to an objective multi-dimensional gait analysis. Background: MS commonly impacts ambulation. Disease impact/progression is commonly measured by PRO, EDSS, adaptive devices or MRI. Quantifying subtle important disease variability not captured by traditional approaches that represent critical thresholds/reserve of progression maybe important to improve clinical decision making to optimize disease modifying therapy choice. Improved objective multi-dimensional metrics could address an unmet need to identify treatment needs contributing to an ability/disability continuum. Design/Methods: Retrospective analysis of PwMS who completed both MSWS-12 and GAITRite, in the course of routine care, each within 6 months. Multivariate regression modeling was used to analyze the relationships between MSWS-12 and 15 objective digital gait domains (DGD). Results:...
PLOS ONE, 2021
Background Multiple Sclerosis (MS) is associated with impaired gait and a growing number of clinical trials have investigated efficacy of various interventions. Choice of outcome measures is crucial in determining efficiency of interventions. However, it remains unclear whether there is consensus on which outcome measures to use in gait intervention studies in MS. Objective We aimed to identify the commonly selected outcome measures in randomized controlled trials (RCTs) on gait rehabilitation interventions in people with MS. Additional aims were to identify which of the domains of the International Classification of Functioning, Disability and Health (ICF) are the most studied and to characterize how outcome measures are combined and adapted to MS severity. Methods Pubmed, Cochrane Central, Embase and Scopus databases were searched for RCT studies on gait interventions in people living with MS according to PRISMA guidelines. Results In 46 RCTs, we identified 69 different outcome me...
Multiple sclerosis journal - experimental, translational and clinical
The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a patient-reported outcome instrument that quantifies the progressive loss of walking ability from the patient perspective. However, previous psychometric analyses indicated floor and ceiling effects across the multiple sclerosis severity spectrum. This study aimed to address floor effects by creating a gait module that can be used in conjunction with the MSWS-12 for better measurement of treatment benefit in the higher functioning multiple sclerosis population. We used a step-wise mixed methods study design, with relapsing-remitting multiple sclerosis patients (wave 1, =88; wave 2, =30), combining qualitative (concept elicitation and cognitive debriefing interviews) and quantitative (Rasch Measurement Theory) data collection and analytical techniques and consultation interviews with three neurologists specializing in multiple sclerosis. Thirty-seven walking ability concepts were identified, and a five-domain conceptual frame...