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The purpose of this study is to compare walking to leg strength and endurance in people with multiple sclerosis (PwMS). Using these findings, we hope to be better understand what causes PwMS to have problems walking.
The purposes of the research are to determine the association of gait performance with lower extremity muscle fatigability and strength measures, and create a preliminary model that can better explain the variance in gait performance based on these muscle performance values. Objective criterion-based measures of physical fatigue (i.e., fatigability) and muscle weakness have been associated with impaired task performance in people with multiple sclerosis (MS). MS-related deficits in muscle capacity result in higher fall risks and a loss of function. However, it is unclear if lower extremity fatigability tests add clinical value to objective strength testing in the rehabilitation and clinical management of MS. Better understanding how patterns of lower extremity (LE) fatigability and strength affect mobility in people with MS could improve outcome measure development and inform rehabilitation strategies.
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| Measure | Description | Time Frame |
|---|---|---|
| Functional Ambulation Performance (FAP) | The FAP is used to quantify self-selected gait. | 1 Day |
| Hip, knee, and ankle fatigability | For isometric tests, a exhaustion time will be calculated by determining the time that peak impulse declines to 50% using a method validated for individual with MS. | 1 Day |
| Hip, knee, and ankle maximal volitional contraction | Maximal volitional contraction will be measured by the load cell using isometric expressed as peak torque. | 1 Day |
| Measure | Description | Time Frame |
|---|---|---|
| Adult Myopathy Assessment Tool (AMAT) | The Adult Myopathy Assessment Tool (0-45 score) is a physical test battery used to evaluate functional performance in individuals with neuromuscular disease. The test consists of 13 measures for functional mobility, balance, strength and endurance to mimic activities of daily living. | 1 Day |
| Measure | Description | Time Frame |
|---|---|---|
| Modified Fatigue Impact Scale (MFIS) | The MFIS is based on items derived from interviews with MS patients concerning how fatigue impacts their lives. This instrument provides an assessment of the effects of fatigue in terms of physical, cognitive, and psychosocial functioning. The MFIS consists of 21 items and is a subscale of the MS Quality of Life Inventory. | 1 Day |
Inclusion Criteria:
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Patients who receive care at the Washington DC Veteran's Affairs Medical Center Neurology Service and Multiple Sclerosis Center of Excellence - East
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Michael Harris-Love, DSc | Contact | (202) 745-8240 | michael.harris-love@va.gov | |
| Kimberly Benson, DPT | Contact | (202) 745-8000 | 55852 | Kimberly.Benson2@va.gov |
| Name | Affiliation | Role |
|---|---|---|
| Michael Harris-Love, DSc | Washington DC VA Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Washington DC VA Medical Center | Washington D.C. | District of Columbia | 20422 | United States |
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| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| D020233 | Gait Disorders, Neurologic |
| D005221 | Fatigue |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
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| 5 times sit to stand test (5STS) |
The 5STS reflects the amount of time required for a participant to complete 5 sit to stand maneuvers without using their hands. For this study we used the 5STS as a measure of functional capacity in people with multiple sclerosis. |
| 1 Day |
| Fatigue Severity Score (FSS) | The FSS is a questionnaire that can indicate severe fatigue related to MS. Scores range from 9-63 with higher scores indicating higher levels of fatigue. | 1 Day |
| Neurology Quality of Life Adult Fatigue Bank (AFB) | The AFB measures are a collection of patient- reported questionnaires and short forms developed with the goal of assessing health-related quality of life (HRQL) across all neurological disorders. | 1 Day |
| Activity Balance Confidence Score (ABC) | The ABC Scale is a 16-item questionnaire that serves as a rating of self-perceived confidence during performance of activities of daily living. Scores range from 0-100 with higher scores indicating greater confidence. | 1 Day |
| BioSensic measure of Reciprocal Compensatory Index (RCI) | BalanSens is a biosensor and is based on widely-available kinematic sensors (i.e. accelerometer, gyroscope and magnetometer). The system measures ankle and hip motion in three dimensions. It allows for object measurement of balance when a patient performs Romberg, sharpened Romberg eyes open and closed and single leg stance. | 1 Day |
| Multiple Sclerosis Spasticity Scale (MSSS-88) | The MSSS-88 is a subjective assessment of day-to-day spasticity symptoms and functional impact in eight clinically separate areas. Scores range from 88-352 and higher scores indicate greater spasticity. | 1 Day |
| Kurtzke Expanded Disability Status Scale (EDSS) | This is a standardized neurological disability scale developed specifically for MS. It accounts broadly for MS symptoms, including things like mobility, mental health, and sensory disturbances. Scores range from 0-10 with higher scores indicating loss of ambulatory ability. | 1 Day |
| Beck Depression Index II (BDI-II) | The BDI-II is a widely used test for measuring depression among individuals. | 1 Day |
| Epworth Sleepiness Scale (ESS) | The ESS is a subjective questionnaire that measures sleep disturbances and excessive sleepiness. Scores range from 0-24, with higher scores indicating greater daytime sleepiness. | 1 Day |
| Montreal Cognitive Assessment (MoCA) | The MoCA is a subject questionnaire that can be used as a screening tool for cognitive dysfunction in people with MS. | 1 Day |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |