Skjerbæk Anders Guldhammer, Hvid Lars G, Boesen Finn, Taul-Madsen Laurits, Stenager Egon, Dalgas Ulrik
The Danish MS Hospitals, Ry and Haslev, Denmark; Exercise Biology, Department of Public Health, Aarhus University, Denmark.
The Danish MS Hospitals, Ry and Haslev, Denmark; Exercise Biology, Department of Public Health, Aarhus University, Denmark.
Mult Scler Relat Disord. 2025 Feb;94:106242. doi: 10.1016/j.msard.2024.106242. Epub 2024 Dec 22.
This review investigated the psychometric properties of the most commonly used short-, long-, complex- and patient-reported walking outcome measures in multiple sclerosis(MS): the timed-25-foot walk test (T25FW), the six-minute walk test (6MWT), the six-spot step-test (SSST), and the 12-item MS walking scale (MSWS-12), along with reported reference data of these tests.
Based on PubMed and Embase searches, psychometric as well as descriptive data of T25FW, 6MWT, SSST, and MSWS-12 were extracted from studies evaluating persons with MS (pwMS). Descriptive data was also extracted from healthy controls (HC), if reported. Data was displayed as median [IQR].
A total of n=84 studies (N=36.929 pwMS, 64% females, age 49.6 [43;51] yrs; N=3.093 HC, 40.0 [37.5;47.5] yrs) were included. In pwMS, expanded disability status scale (EDSS) was 4.0 [3.0;4.8], patient determined disease scale (PDDS) 2.6 [2.0;3.0], time since diagnosis 11.6 [9.9;13.2] yrs, and MS-phenotypes (RR/SP/PP/unknown) were 68/19/10/3%. PwMS performed substantially worse than HC across all walking capacity outcomes. Weak to strong associations were found for construct validity (r=0.29-0.88, EDSS or PDDS and walking capacity or ability outcomes) and concurrent validity (r=0.16-0.88 between walking capacity and ability, r=0.73-0.95 between walking capacity outcomes). Ecological validity showed weak to moderate associations between daily steps and walking outcomes (r=0.42-0.68). Good to excellent test-retest, intrarater, and interrater reliability were reported across outcomes (ICC=0.71-1.00). Responsiveness was most frequently reported as the minimal-clinically-important-difference, minimal-detectable-change, or as the minimal-important-change (data not shown).
Overall the T25FW, 6MWT, SSST, and MSWS-12 demonstrate moderate to excellent psychometric properties (i.e., valid, reliable, and responsive to changes), which make them clinically useful and applicable to research.
本综述研究了多发性硬化症（MS）中最常用的短程、长程、复杂和患者报告的步行结局测量指标的心理测量特性：25英尺计时步行测试（T25FW）、6分钟步行测试（6MWT）、六点阶梯测试（SSST）和12项MS步行量表（MSWS - 12），以及这些测试报告的参考数据。
基于PubMed和Embase搜索，从评估MS患者（pwMS）的研究中提取T25FW、6MWT、SSST和MSWS - 12的心理测量以及描述性数据。如果有报告，也从健康对照（HC）中提取描述性数据。数据以中位数[四分位间距]表示。
共纳入n = 84项研究（N = 36929例pwMS，64%为女性，年龄49.6[43;51]岁；N = 3093例HC，40.0[37.5;47.5]岁）。在pwMS中，扩展残疾状态量表（EDSS）为4.0[3.0;4.8]，患者确定疾病量表（PDDS）为2.6[2.0;3.0]，诊断后时间为11.6[9.9;13.2]年，MS表型（复发缓解型/继发进展型/原发进展型/未知）分别为68/19/10/3%。在所有步行能力结局方面，pwMS的表现明显比HC差。在结构效度（r = 0.29 - 0.88，EDSS或PDDS与步行能力或功能结局之间）和同时效度（步行能力与功能之间r = 0.16 - 0.88，步行能力结局之间r = 0.73 - 0.95）方面发现了弱到强的相关性。生态效度显示日常步数与步行结局之间存在弱到中等的相关性（r = 0.42 - 0.68）。各结局的重测信度、评定者内信度和评定者间信度均报告为良好到优秀（ICC = 0.71 - 1.00）。反应度最常报告为最小临床重要差异、最小可检测变化或最小重要变化（数据未显示）。
总体而言，T25FW、6MWT、SSST和MSWS - 12表现出中等至优秀的心理测量特性（即有效、可靠且对变化有反应），这使其在临床上有用且适用于研究。
