Departments of Neurology, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo, Hokkaido 063-0005, Japan; Departments of Clinical Research, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo, Hokkaido 063-0005, Japan.
Departments of Clinical Research, National Hospital Organization Hokkaido Medical Center, 1-1 Yamanote, 5-jo 7-chome, Nishi-ku, Sapporo, Hokkaido 063-0005, Japan.
Mult Scler Relat Disord. 2024 Sep;89:105768. doi: 10.1016/j.msard.2024.105768. Epub 2024 Jul 11.
Disability in ambulation has a critical impact on activities of daily living in patients with multiple sclerosis (MS). The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a self-reported instrument developed to assess the impact of MS on walking. The scale's 12 items assess various aspects of walking-related tasks during the past 2 weeks. MSWS-12 has been used in multiple clinical studies and translated into several languages. In the present study, we translated the MSWS-12 into Japanese and evaluated its psychometric properties in a cross-sectional study.
The original English MSWS-12 version 2 (v2) was translated into Japanese through a standard procedure. Sixty consecutive Japanese MS patients completed the newly prepared Japanese MSWS-12v2 questionnaire and repeated the test 14 days later. Physical disability was assessed by the Expanded Disability Status Scale (EDSS), Timed 25-foot Walk (T25FW), and 9-hole Peg Test (9HPT). Cognitive performance was evaluated using the Processing Speed Test (PST). Fatigue and health-related quality of life were assessed using the Japanese versions of the Fatigue Severity Scale (FSS) and the Functional Assessment of MS (FAMS).
The mean age of the patients was 42.5 years, with median disease duration of 10 years, and median EDSS of 2.0 (range 0, 6.5). Forty-seven patients (78.3 %) had relapsing-remitting, 9 (15.0 %) had secondary-progressive, and 4 (6.7 %) had primary-progressive phenotypes. The median score of the MSWS-12v2 was 5.95 (interquartile range 0, 50.6). Twenty-seven patients (45 %) scored the lowest possible score (0 points), while one (1.7 %) scored the highest possible score (100 points). Cronbach's alpha was 0.98 (95 % confidence interval [CI] 0.97, 0.98), and the test-retest intraclass correlation was 0.95 (95%CI 0.94, 0.96). MSWS-12v2 score was strongly correlated with EDSS (Spearman's ρ = 0.73 [95%CI 0.58, 0.83]), T25FW (ρ = 0.70 [95%CI 0.55, 0.81]), and total FAMS score (ρ = -0.80 [95%CI -0.88, -0.69]), and moderately correlated with 9HPT (ρ = 0.65 [95%CI 0.47, 0.77] for the dominant hand; ρ = 0.62 [95%CI 0.43, 0.75] for the non-dominant hand), PST (ρ = -0.65 [95%CI -0.78, -0.47]), and FSS (ρ = 0.68 [95%CI 0.52, 0.80]). Among the subcomponents of FAMS, the mobility subcomponent showed the most robust correlation with MSWS-12v2 score (ρ = -0.91 [95%CI -0.94, -0.81]). In patients with minimal or no objective disability (EDSS < 3.0, n = 40), only the mobility subcomponent of FAMS was strongly correlated with MSWS-12v2 score (ρ = -0.76 [95% CI -0.87, -0.58]). In contrast, correlations of MSWS-12v2 score with EDSS and T25FW were weak in this subgroup (ρ = 0.28 [95%CI -0.03, 0.55] for EDSS; ρ = 0.25 [95%CI -0.06, 0.52] for T25FW). Response patterns for the single items showed that 32.5 % of the patients with EDSS below 3.0 reported having problems with balance, followed by climbing stairs and standing while doing things (both 25 %).
The Japanese version of the MSWS-12v2 developed in this study is reliable, valid, and helpful for screening walking disability in Japanese MS patients, including those with minimal objective disability.
多发性硬化症（MS）患者的步行障碍对日常生活活动有重大影响。12 项多发性硬化症步行量表（MSWS-12）是一种自我报告工具，用于评估 MS 对步行的影响。该量表的 12 个项目评估了过去 2 周内与行走相关任务的各个方面。MSWS-12 已在多项临床研究中使用，并翻译成多种语言。在本研究中，我们将 MSWS-12 翻译成日语，并在一项横断面研究中评估其心理测量特性。
原始的英文 MSWS-12 版本 2（v2）通过标准程序翻译成日语。60 名连续的日本 MS 患者完成了新准备的日本 MSWS-12v2 问卷，并在 14 天后重复测试。身体残疾通过扩展残疾状况量表（EDSS）、定时 25 英尺步行（T25FW）和 9 孔钉测试（9HPT）评估。认知表现使用处理速度测试（PST）进行评估。疲劳和健康相关生活质量使用日本版疲劳严重程度量表（FSS）和多发性硬化症功能评估量表（FAMS）进行评估。
患者的平均年龄为 42.5 岁，中位病程为 10 年，中位 EDSS 为 2.0（范围 0，6.5）。47 名患者（78.3%）为复发缓解型，9 名（15.0%）为继发进展型，4 名（6.7%）为原发进展型。MSWS-12v2 的中位数评分为 5.95（四分位距 0，50.6）。27 名患者（45%）得分最低（0 分），1 名患者（1.7%）得分最高（100 分）。Cronbach's alpha 为 0.98（95%置信区间[CI] 0.97，0.98），测试-重测的组内相关系数为 0.95（95%CI 0.94，0.96）。MSWS-12v2 评分与 EDSS（Spearman's ρ = 0.73 [95%CI 0.58，0.83]）、T25FW（ρ = 0.70 [95%CI 0.55，0.81]）和总 FAMS 评分（ρ = -0.80 [95%CI -0.88，-0.69]）呈强相关，与 9HPT（优势手 ρ = 0.65 [95%CI 0.47，0.77]；非优势手 ρ = 0.62 [95%CI 0.43，0.75]）、PST（ρ = -0.65 [95%CI -0.78，-0.47]）和 FSS（ρ = 0.68 [95%CI 0.52，0.80]）呈中度相关。在 FAMS 的亚组分中，移动亚组分与 MSWS-12v2 评分的相关性最强（ρ = -0.91 [95%CI -0.94，-0.81]）。在仅有轻微或无客观残疾（EDSS < 3.0，n = 40）的患者中，仅 FAMS 的移动亚组分与 MSWS-12v2 评分呈强相关（ρ = -0.76 [95%CI -0.87，-0.58]）。在该亚组中，MSWS-12v2 评分与 EDSS 和 T25FW 的相关性较弱（ρ = 0.28 [95%CI -0.03，0.55] 用于 EDSS；ρ = 0.25 [95%CI -0.06，0.52] 用于 T25FW）。单项的反应模式显示，EDSS 低于 3.0 的 32.5%的患者报告存在平衡问题，其次是爬楼梯和站着做事（均为 25%）。
本研究中开发的日本版 MSWS-12v2 可靠、有效，有助于筛选日本 MS 患者的步行障碍，包括仅有轻微客观残疾的患者。
Zotero 插件