Hpt validating performance measures
Such features collectively justify its role in the Multiple Sclerosis Outcome Assessments Consortium (MSOAC), an effort to adopt a clinical outcome assessment tool for clinical trials to better capture MS-related disability.
The MSOAC was born out of a consensus paper by the International Advisory Committee on Clinical Trials in Multiple Sclerosis.
This three-part, standardized assessment was developed for clinical trials in MS by a task force on clinical outcomes assessment by the National Multiple Sclerosis Society (NMSS) and provided a multidimensional outcome that (a) reflects the varied clinical expression of MS, (b) contains dimensions that can change independently over time, and (c) measures cognitive function as well as leg function/ambulation and arm/hand function.
The MSFC has been included in a large number of clinical trials but has been criticized based on its (a) expression as a The MSFC further has not been accepted by regulators as a primary endpoint in clinical trials.
The outcome of walking speed from the T25FW has obvious real-world relevance and has correlated strongly with other measures of walking and lower extremity function.
The T25FW is responsive for capturing intervention effects in pharmacological and rehabilitation trials and has an established value for capturing clinically meaningful change in ambulation.
This article addresses the history, application, and psychometric properties of one such MSOAC metric of ambulation or walking namely, the timed 25-foot walk (T25FW).
The T25FW has strong reliability over both brief and long periods of time in MS across a large range of disability levels.
This review benefitted from a formal MSOAC-sponsored literature search, conducted in Embase, MEDLINE, Psyc Info, and Cumulative Index of Nursing and Allied Health Literature, followed by an enrichment technique (key papers identified by MSOAC members added and informed search criteria) including work identified from prior reviews.
Walking dysfunction was recognized as a cardinal feature of MS in the earliest historical accounts of the disease Such observations underscore the importance of walking as an outcome in clinical research and practice involving MS patients. The Expanded Disability Status Scale (EDSS), which is the most common scale to measure disability in MS, classifies walking or ambulatory dysfunction based on EDSS scores of 4.0 or greater (e.g.
able to walk 500 vs 300 m without aid or rest differentiates a 4.0 and 4.5, respectively, on the EDSS).
Directions for future research involve validating clinically meaningful improvements on the T25FW as well as determining whether 20% change is clinically meaningful across the disability spectrum.
Researchers might further consider synchronizing accelerometers and motion sensors with the T25FW for capturing walking speed in everyday life and the patient's real environment.