Motl Robert W, Learmonth Yvonne C, Pilutti Lara A, Dlugonski Deirdre, Klaren Rachel
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Ill., USA.
Eur Neurol. 2014;71(3-4):196-202. doi: 10.1159/000356116. Epub 2014 Jan 21.
Minimal clinically important difference (MCID) values of 4 and 6 points have been proposed for interpreting meaningful change in Multiple Sclerosis Walking Scale-12 (MSWS-12) scores. This study examined the validity of those MCID values based on capturing corresponding changes in other walking outcomes in persons with multiple sclerosis (MS).
On 2 occasions separated by 6 months, 82 persons with MS completed the MSWS-12, timed 25-ft walk (T25FW), 6-min walk (6MW), and gait analysis, and then wore an accelerometer over a 7-day period. We generated change scores for the MSWS-12 and formed groups of stable, worsened, and improved perceived walking based on both 4- and 6-point changes. The groups were compared for corresponding changes in other walking measures over time using mixed-model ANOVAs.
The mixed-model ANOVAs did not identify statistically significant group-by-time interactions on the T25FW (p = 0.98 and p = 0.67), the 6MW (p = 0.89 and p = 0.72), gait (p = 0.54 and p = 0.21), or accelerometry (p = 0.40 and p = 0.68) for MCID values of 4- or 6-point changes in MSWS-12 scores.
We did not confirm that MCID values of 4 and 6 points for the MSWS-12 correspond with changes in performance, gait, and free-living assessments of walking in MS.
对于解读多发性硬化症步行量表12项（MSWS - 12）评分中有意义的变化，已提出4分和6分的最小临床重要差异（MCID）值。本研究基于捕捉多发性硬化症（MS）患者其他步行结果的相应变化，检验了这些MCID值的有效性。
82例MS患者在间隔6个月的两个时间点完成了MSWS - 12、25英尺步行计时测试（T25FW）、6分钟步行测试（6MW）和步态分析，然后在7天内佩戴加速度计。我们生成了MSWS - 12的变化分数，并根据4分和6分的变化形成了感知步行稳定、恶化和改善的组。使用混合模型方差分析比较这些组在其他步行测量指标上随时间的相应变化。
对于MSWS - 12评分中4分或6分变化的MCID值，混合模型方差分析未在T25FW（p = 0.98和p = 0.67）、6MW（p = 0.89和p = 0.72）、步态（p = 0.54和p = 0.21）或加速度测量（p = 0.40和p = 0.68）上发现具有统计学意义的组×时间交互作用。
我们未证实MSWS - 12的4分和6分MCID值与MS患者步行的表现、步态及日常生活评估中的变化相对应。
