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Responsiveness and meaningful improvement of mobility measures following MS rehabilitation

Baert, Ilse
Autor Baert, Ilse From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark. ilse.baert@uhasselt.be
Smedal, Tori
Autor Smedal, Tori From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Kalron, Alon
Autor Kalron, Alon From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Rasova, Kamila
Autor Rasova, Kamila From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Heric-Mansrud, Adnan
Autor Heric-Mansrud, Adnan From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Ehling, Rainer
Autor Ehling, Rainer From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Elorriaga Minguez, Iratxe
Autor Elorriaga Minguez, Iratxe From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Nedeljkovic, Una
Autor Nedeljkovic, Una From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Tacchino, Andrea
Autor Tacchino, Andrea From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark
Hellinckx, Peter
Autor Hellinckx, Peter From the REVAL Rehabilitation Research Center (I.B., P.F.), BIOMED Biomedical Research Institute, Faculty of Medicine & Life Sciences, Hasselt University, Belgium Haukeland University Hospital (Norwegian MS Competence Centre and Department of Physiotherapy) (T.S.), Bergen, Norway Department of Physical Therapy (A.K.), Sackler Faculty of Medicine, Tel-Aviv University Multiple Sclerosis Center (A.K.), Sheba Medical Center, Tel-Hashomer, Israel Department of Rehabilitation, Third Faculty of Medicine (K.R.), Charles University and Faculty Hospital Royal Vineyards, Prague, Czech Republic Multiple Sclerosis Center (A.H.-M.), Hakadal AS, Norway Department of Neurology (R.E.), Clinic for Rehabilitation Münster, Austria Eugenia Epalza Rehabilitation Center (I.E.M.), Bilbao, Spain Clinical Center in Belgrado (U.N.), Serbia Italian Multiple Sclerosis Foundation (FISM) (A.T.), Scientific Research Area, Genoa, Italy National MS Center (P.H.), Melsbroek AZ Klina (G.A.), Campus De Mick, Rehabilitation, Brasschaat, Belgium John Paul II Rehabilitation Centre for People with Multiple Sclerosis (G.S.), Borne Sulinowo, Poland Neurological Rehabilitation Centre Quellenhof (K.G.), Sana AG, Germany IRCSS Fondazione Don Carlo Gnocchi (D.C.), Milan, Italy Rehabilitation and MS Center Overpelt (S.B.), Belgium University of Colorado-Anschutz Medical Campus (J.H.) and Section of Sport Science (U.D.), Department Public Health, Aarhus University, Denmark

Neurology. 2018 ; 91 (20) : e1880-e1892. [pub] 20181017

ISSN 1526-632X
Medvik
Zdroj

OBJECTIVE: To determine responsiveness of functional mobility measures, and provide reference values for clinically meaningful improvements, according to disability level, in persons with multiple sclerosis (pwMS) in response to physical rehabilitation. METHODS: Thirteen mobility measures (clinician- and patient-reported) were assessed before and after rehabilitation in 191 pwMS from 17 international centers (European and United States). Combined anchor- and distribution-based methods were used. A global rating of change scale, from patients' and therapists' perspective, served as external criteria when determining the area under the receiver operating characteristic curve (AUC), the minimally important change (MIC), and the smallest real change (SRC). Patients were stratified into 2 subgroups based on disability level (Expanded Disability Status Scale score ≤4 [n = 72], >4 [n = 119]). RESULTS: The Multiple Sclerosis Walking Scale-12, physical subscale of the Multiple Sclerosis Impact Scale-29 (especially for the mildly disabled pwMS), Rivermead Mobility Index, and 5-repetition sit-to-stand test (especially for the moderately to severely disabled pwMS) were the most sensitive measures in detecting improvements in mobility. Findings were determined once the AUC (95% confidence interval) was above 0.5, MIC was greater than SRC, and results were comparable from the patient and therapist perspective. CONCLUSIONS: Responsiveness, clinically meaningful improvement, and real changes of frequently used mobility measures were calculated, showing great heterogeneity, and were dependent on disability level in pwMS.

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