Özden Fatih, Özkeskin Mehmet, Ekici Ece, Yüceyar Nur
Department of Health Care Services, Köyceğiz Vocational School of Health Services, Muğla Sıtkı Koçman University, Muğla, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, İzmir, Turkey.
Neurol Sci. 2024 Jan;45(1):241-248. doi: 10.1007/s10072-023-06983-7. Epub 2023 Aug 3.
To our knowledge, no studies compared the video-clinician-based tools and patient-reported questionnaires in assessing gait and balance in people with MS (pwMS). The present study investigated the correlation and agreement between video-clinician-based objective measurement tools and patient-reported outcome measures (PROMs) in gait and balance evaluation.
A prospective cross-sectional study was conducted with 55 pwMS. Video analysis-based gait was evaluated by the Tinetti Gait Assessment (TGA), Gait Assessment and Intervention Tool (GAIT), and Functional Ambulation Classification Scale (FACS) by the clinician. Participants' self-reported gait and balance were assessed with the Multiple Sclerosis Walking Scale-12 (MSWS-12) and Activity-Specific Balance Confidence Scale (ABC).
There was a moderate positive correlation between ABC with TGA and FACS (r: 0.552, r: 0.510, p < 0.001). ABC was strongly correlated with GAIT (r: - 0.652, p < 0.001). A moderate positive correlation was observed between MSWS-12 with TGA and FACS (r: - 0.575, r: - 0.524, p < 0.001). In addition, there was a strong positive correlation between MSWS-12 and GAIT (r: - 0.652, p < 0.001). Clinician-rated tools and PROMs were within the agreement limits regarding the unstandardized beta values p < 0.001).
Clinician-based gait and balance tools demonstrate consistent results with PROMs in pwMS. Considering the low cost and practical use of PROMs, in cases where video-based clinician-based measurements cannot be provided (time, space, and technical inadequacies), questionnaires can provide concordant results at moderate and severe levels compared with objective tools.
据我们所知，尚无研究比较基于视频临床医生的工具与患者报告的问卷在评估多发性硬化症患者（pwMS）步态和平衡方面的差异。本研究调查了基于视频临床医生的客观测量工具与患者报告结局测量（PROMs）在步态和平衡评估中的相关性和一致性。
对55例pwMS患者进行了一项前瞻性横断面研究。临床医生通过Tinetti步态评估（TGA）、步态评估与干预工具（GAIT）和功能步行分类量表（FACS）对基于视频分析的步态进行评估。使用多发性硬化症步行量表-12（MSWS-12）和特定活动平衡信心量表（ABC）评估参与者自我报告的步态和平衡情况。
ABC与TGA和FACS之间存在中度正相关（r：0.552，r：0.510，p < 0.001）。ABC与GAIT高度相关（r： - 0.652，p < 0.001）。MSWS-12与TGA和FACS之间存在中度正相关（r： - 0.575，r： - 0.524，p < 0.001）。此外，MSWS-12与GAIT之间存在高度正相关（r： - 0.652，p < 0.001）。临床医生评分工具和PROMs在未标准化β值方面处于一致范围内（p < 0.001）。
基于临床医生的步态和平衡工具在pwMS患者中与PROMs显示出一致的结果。考虑到PROMs成本低且实用性强，在无法提供基于视频临床医生测量的情况下（时间、空间和技术不足），与客观工具相比，问卷在中度和重度水平上可提供一致的结果。
