Clinical Importance of Steps Taken per Day among Persons with Multiple SclerosisReportar como inadecuado




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Background

The number of steps taken per day steps-day provides a reliable and valid outcome of free-living walking behavior in persons with multiple sclerosis MS.

Objective

This study examined the clinical meaningfulness of steps-day using the minimal clinically important difference MCID value across stages representing the developing impact of MS.

Methods

This study was a secondary analysis of de-identified data from 15 investigations totaling 786 persons with MS and 157 healthy controls. All participants provided demographic information and wore an accelerometer or pedometer during the waking hours of a 7-day period. Those with MS further provided real-life, health, and clinical information and completed the Multiple Sclerosis Walking Scale-12 MSWS-12 and Patient Determined Disease Steps PDDS scale. MCID estimates were based on regression analyses and analysis of variance for between group differences.

Results

The mean MCID from self-report scales that capture subtle changes in ambulation 1-point change in PDSS scores and 10-point change in MSWS-12 scores was 779 steps-day 14% of mean score for MS sample; the mean MCID for clinical-health outcomes MS type, duration, weight status was 1,455 steps-day 26% of mean score for MS sample; real-life anchors unemployment, divorce, assistive device use resulted in a mean MCID of 2,580 steps-day 45% of mean score for MS sample; and the MCID for the cumulative impact of MS MS vs. control was 2,747 steps-day 48% of mean score for MS sample.

Conclusion

The change in motion sensor output of ∼800 steps-day appears to represent a lower-bound estimate of clinically meaningful change in free-living walking behavior in interventions of MS.



Autor: Robert W. Motl , Lara A. Pilutti, Yvonne C. Learmonth, Myla D. Goldman, Ted Brown

Fuente: http://plos.srce.hr/



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