Highlights
- •The EDSS is disproportionately influenced by the ability to walk.
- •Some PwMS do not accurately predict maximum walking distance.
- •In nearly half of cases, this inaccurate estimation changed EDSS score.
- •A formal walking assessment should be considered to increase the accuracy of EDSS scoring.
Abstract
Background
In persons with MS (PwMS), the Expanded Disability Status Scale (EDSS) is used to
monitor disability progression. Scores between 4.0 and 7.0 are determined by maximum
walking distance. Self-estimation of this value is often employed in clinic settings.
Objective
To examine the accuracy with which PwMS estimate their walking distance, and observe
subsequent changes to the EDSS.
Methods
This prospective cohort study recruited PwMS with previously recorded EDSS of 3.5–7.0.
Participants estimated their maximum walking distance and then walked as far as they
could along a pre-specified course. Each distance was converted to an EDSS score,
the “estimated EDSS” and the “actual EDSS”. Chi-Square analysis was used to compare
EDSS scores. Logistic regression was used to determine predictors of inaccurate estimations.
Results
Of the 66 PwMS in this study, 43.9% had a difference in the actual EDSS compared to
the estimated EDSS. Median estimated EDSS was 4.75 (range 3.0–7.0); after walking
assessment, median actual EDSS was 5.0 (range 3.0–7.0), which represented a significant
difference [X2 (df 64, N = 66) = 206.9; p < 0.001]. Actual EDSS decreased in 9 PwMS (13.6%) and increased in 20 PwMS (30.3%).
Logistic regression did not find any demographic/disease characteristic to be predictive
of this discrepancy.
Conclusion
Some PwMS do not accurately estimate maximum walking distance; only 56.1% of PwMS
accurately estimated their actual EDSS.
Keywords
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Article info
Publication history
Published online: May 17, 2017
Accepted:
May 16,
2017
Received in revised form:
May 15,
2017
Received:
December 27,
2016
Footnotes
☆This research was funded by an investigator initiated trial grant from Genzyme Canada.
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
