ECTRIMS eLearning

A preliminary investigation into the relationship between the Multiple Sclerosis Walking Scale (MSWS-12) and an objective multi-dimensional digital gait analysis
Author(s): ,
M. Gudesblatt
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
S. Trebing
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
C. Burke
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
S. Tan
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
K. Wissemann
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
J. Srinivasan
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
R. Julius
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
M. Zarif
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
B. Bumstead
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
,
L. Fafard
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
M. Buhse
Affiliations:
South Shore Neurologic Association PC, Patchogue, NY, United States
ECTRIMS Learn. Gudesblatt M. 10/10/18; 229247; EP1408
Mark Gudesblatt
Mark Gudesblatt
Contributions
Abstract

Abstract: EP1408

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Clinical assessment tools

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.
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: 16 PwMS (50% female, average age = 55.7±10.8) completed testing. DGD correlations were: 80% (12/15) high-strength (r≥0.50) with MSWS-12 including- base of support (r=0.69, p< 0.01), stride-length (right r=0.71, p< 0.01; left r=0.71, p< 0.01) legs, step-length (right r=0.69, P< 0.01; left r=0.73, p< 0.01) legs, % gait-cycle double-support (r=0.66, p< 0.01), % gait-cycle single-leg support (right r=0.54, p< 0.05; left r=0.72, p< 0.01), leg-stance (right r=0.58, p< 0.05; left r=0.55, p< 0.05), cycle-time (r=0.55, p< 0.05), step-time (right r=0.60, p< 0.05; left r=0.57, p< 0.05), step-time differential (r=0.50, p< 0.10), cadence (r=0.50, p< 0.10), mean normalized velocity (r=0.66, p< 0.01), and functional ambulation profile score (r=0.67, p< 0.01); 7% (2/15) medium strength (0.30≤r≤0.49) including- swing-time (right r=0.35, p< 0.20, left r=0.42, p< 0.15) legs; and 7% (2/15) were low strength (r≤0.29) including- cycle-time differential (r=0.04, p>0.85), step-length differential (r=0.23, p>0.25).
Conclusions: Multiple unique important and quantifiable objective gait domains underlie ambulatory function and defines PRO centric walking ability/disability. A PRO scale is insufficient to provide such quantitative granular objective patient-centric data as obtained by objective, multi-dimensional approaches to identify/define disease impact/change.
Disclosure: This study was not supported by outside funds:
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
JS- Nothing to disclose
Stacy Trebing- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
MB: Nothing to disclose
CB: Nothing to disclose
LF- Nothing to disclose
DG- Nothing to disclose
Sean Tan- Nothing to disclose
RJ- Nothing to disclose

Abstract: EP1408

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Clinical assessment tools

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.
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: 16 PwMS (50% female, average age = 55.7±10.8) completed testing. DGD correlations were: 80% (12/15) high-strength (r≥0.50) with MSWS-12 including- base of support (r=0.69, p< 0.01), stride-length (right r=0.71, p< 0.01; left r=0.71, p< 0.01) legs, step-length (right r=0.69, P< 0.01; left r=0.73, p< 0.01) legs, % gait-cycle double-support (r=0.66, p< 0.01), % gait-cycle single-leg support (right r=0.54, p< 0.05; left r=0.72, p< 0.01), leg-stance (right r=0.58, p< 0.05; left r=0.55, p< 0.05), cycle-time (r=0.55, p< 0.05), step-time (right r=0.60, p< 0.05; left r=0.57, p< 0.05), step-time differential (r=0.50, p< 0.10), cadence (r=0.50, p< 0.10), mean normalized velocity (r=0.66, p< 0.01), and functional ambulation profile score (r=0.67, p< 0.01); 7% (2/15) medium strength (0.30≤r≤0.49) including- swing-time (right r=0.35, p< 0.20, left r=0.42, p< 0.15) legs; and 7% (2/15) were low strength (r≤0.29) including- cycle-time differential (r=0.04, p>0.85), step-length differential (r=0.23, p>0.25).
Conclusions: Multiple unique important and quantifiable objective gait domains underlie ambulatory function and defines PRO centric walking ability/disability. A PRO scale is insufficient to provide such quantitative granular objective patient-centric data as obtained by objective, multi-dimensional approaches to identify/define disease impact/change.
Disclosure: This study was not supported by outside funds:
MG- Research support (Biogen, EMD Serono, Novartis, Sanofi, Teva); speaker fees/consultant (Acorda, Amgen, Biogen, EMD Serono, Medtronic, Novartis, Sanofi, Saol Therapeutics, Teva).
JS- Nothing to disclose
Stacy Trebing- Nothing to disclose
MZ- Speaker fees (Acorda, Biogen, Genzyme and Teva)
BB- Speaker fees (Biogen, Genotech, Genzyme and Teva).
MB: Nothing to disclose
CB: Nothing to disclose
LF- Nothing to disclose
DG- Nothing to disclose
Sean Tan- Nothing to disclose
RJ- Nothing to disclose

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