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Clinical relevance using timed walk tests and 'timed up and go' testing in persons with multiple sclerosis
Örebro University, Department of Clinical Medicine.ORCID iD: 0000-0002-9760-3785
Örebro University, Department of Clinical Medicine.ORCID iD: 0000-0002-4192-8273
2007 (English)In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 12, no 2, p. 105-14Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE: One must understand the potentials and limitations of all tests used to evaluate interventions. The aim of the present study was to clarify the reproducibility, smallest percentage difference needed to be able to detect a genuine change and correlation regarding the 10-m and 30-m timed walks (10TW 30TW) and the 'timed up and go' (TUG) test in people with moderate multiple sclerosis (MS).

METHOD: A repeated-measures design was used, with randomization into two groups and different time intervals used for testing. The 10TW and 30TW were performed three times and TUG twice at each testing. Self-selected speed was used for 10TW and forced speed (quickly but safely) for 30TW and TUG. Forty-three people were tested on three occasions within one week. Each person was tested at approximately the same time of the day and by the same physiotherapist on each occasion.

RESULTS: The reproducibility was very high. For a single testing occasion, the intraclass correlation was 0.97 for the 10TW and 0.98 for the 30TW and TUG. The smallest percentage difference needed to be able to detect a genuine change in the entire study group was approximately -23% or +31% for either the 1OTW or TUG. It was evident from the 30TW testing results that lower values applied to those with less (-14% to +17%) rather than more (-38% or +60%) disability. The correlation between all tests for the entire study group was 0.85 (0.76-0.91).

CONCLUSION: It is sufficient to use only one attempt and to choose only one of the tests when evaluating people with moderate MS. In the case of the 30TW greater attention must be paid to the degree of disability when determining the smallest percentage difference needed to establish a genuine change, than

Place, publisher, year, edition, pages
London: Whurr Publishers , 2007. Vol. 12, no 2, p. 105-14
Keywords [en]
Adult, Cross-Over Studies, Female, Gait/physiology, Humans, Locomotion/physiology, Male, Middle Aged, Motor Activity/*physiology, Multiple Sclerosis/physiopathology/*rehabilitation, Musculoskeletal Equilibrium/physiology, Reproducibility of Results, Time Factors, Walking/*physiology
National Category
Physiotherapy
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-4699DOI: 10.1002/pri.358PubMedID: 17536648OAI: oai:DiVA.org:oru-4699DiVA, id: diva2:138998
Available from: 2008-11-12 Created: 2008-11-12 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Walking ability, balance and accidental falls in persons with Multiple Sclerosis
Open this publication in new window or tab >>Walking ability, balance and accidental falls in persons with Multiple Sclerosis
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

By using a pragmatic paradigm, different research methodologies were employed in this thesis. MS-related symptoms may be exaggerated due to heatsensitivity and it is supposed that cooling garments relieve the symptoms. The effects of wearing a Rehband® vest were evaluated in a sample of 42 persons with MS in a randomised controlled crossover study. Both objective and subjective statistically significant improvements were found when a cooled Rehband® vest was worn compared to the wearing of a room-tempered vest. Using a repeated-measures design, 10m and 30m timed walks and Timed Up and Go were studied in 42 persons with MS. Reproducibility was investigated within and between test points. High reproducibility was found both within (r=0.97–0.98) and between measure points (r=0.91–0.93). The correlation between the three tests was high (r=0.85). Differences at –23% to +40% were established as being needed to detect genuine changes. Severity of MS infl uenced the size of the differences, especially for the 30m timed walk test. The 12-item MS Walking Scale was translated and used in a cross-sectional study. Out of 81 persons with MS, 89–96% perceived limitations in standing or walking. The internal consistency of the scale was acceptable for nine items (0.69–0.84). The concurrent validity between the 12-item MS Walking Scale and the investigated objective tests was low: Berg Balance Scale (r=–0.368**), Four Square Step Test (r=0.338**) and Timed Up and Gocognitive (r=0.319*).

A prevalence of falling was found at 63% in a longitudinal cohort study with prospectively registered falls including 76 persons with MS. The odds of falling were fi ve fold when there was a reported need of using a walking aid indoors and outdoors and by 2.5 to 15.6 times while there was disturbed proprioception, depending on severity. The highest sensitivity was found for the Berg Balance Scale (94%) and the highest specifi city was found for the 12-item MS Walking Scale (82%). Positive predictive values at 70–83% were found for the Berg Balance Scale, Timed Up and Gocognitive, the Four Square Step Test and the 12-item MS Walking Scale. Finally, we explored and described factors that persons with MS perceive as related to accidental falls. A content analysis with a deductive approach was chosen. By conducting interviews, we found previously untargeted factors: divided attention, reduced muscular endurance, fatigue and heat-sensitivity. The content of the interviews also gave support to previously reported risk factors such as changes in gait pattern, walking disability, impaired proprioception and vision, and spasticity.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2008. p. 94
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 21
Keywords
multiple sclerosis, cooling garment, gait, walking, balance, reliability, validity, accidental falls, prediction, ICF
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-2518 (URN)978-91-7668-631-7 (ISBN)
Public defence
2008-11-21, Wilandersalen, USÖ, M-huset, 701 85, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2008-10-15 Created: 2008-10-15 Last updated: 2017-10-18Bibliographically approved

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Nilsagård, YlvaGunnarsson, Lars-Gunnar

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