1,721,074 research outputs found
Intermediate outcomes for clinical trials of multiple sclerosis rehabilitation interventions: Conceptual and practical considerations
No full textBackground:Rehabilitation is an essential health care service and a critical component of comprehensive multiple sclerosis (MS) care. Objective:As part of a 2-day meeting hosted by the International Advisory Committee on Clinical Trials in MS in December 2022, a panel initiated a discussion on the conceptual and practical issues related to selecting intermediate outcomes for clinical trials of MS rehabilitation interventions. Results:The overarching goal of rehabilitation - optimal functioning - was acknowledged as a complex biopsychosocial phenomenon that varies with patient priorities and environmental context. This complexity means that multiple causal pathways and potential intermediate outcomes must be carefully considered during the design of clinical trials in MS rehabilitation that aim to improve functioning. In addition, practical issues must be considered such as psychometric properties of outcome measures, measure type, and characteristics of the target population, including severity of dysfunction. Conclusion:This article uses the International Classification of Functioning, Disability and Health as a foundation for determining relevant intermediate outcomes for clinical trials of MS rehabilitation interventions.The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The International Advisory Committee on Clinical Trials in Multiple Sclerosis and the International Conference on Innovations in Clinical Trial Design & Enhancing Inclusivity of Clinical Trial Populations were supported by the National Multiple Sclerosis Society and the European Committee for Treatment and Research in Multiple Sclerosis. There was no involvement of the sponsors in the design, collection, analysis or interpretation of data discussed at the Conference. The opinions expressed are those of the authors. Open access was made possible by the participation of Queen’s University in the Canadian Research Knowledge Network
Coordinating and coaching: the role ambiguity for non-medical Return To Work (RTW) care services
No full textCoordinating and coaching: the role ambiguity for non-medical Return To Work (RTW) care services
No full textCoordinating and coaching: the role ambiguity for non-medical Return To Work (RTW) care services
No full textCoordinating and coaching: the role ambiguity for non-medical Return To Work (RTW) care services
No full textTapping to music and metronome ticks at high and low tempi in persons with progressive MS
No full textExpanding the walking fatigability definition in people with multiple sclerosis: An exploratory study
No full textObjective: To investigate the relationship of the 6MWT and walking fatigability with different domains of physical activity in pwMS with WF (MS-WF), non-WF (MS-NWF) and healthy controls (HC). Methods: Twenty-two MS-WF (EDSS 4.7±1.1; 15F/7M), 21 NWF-MS (EDSS: 4.9±1.2; 15F/6M) and 21 HC (18F/3M) responded to the international physical activity questionnaire (IPAQ-long version) and performed the 6MWT. IPAQ was calculated in metabolic equivalent of task for moderate, vigorous and total physical activities domains. Total and minute-by-minute distances were recorded in the 6MWT, and the distance walked index from the last minute (DWI 6-1) was calculated for WF. Spearman's rank correlation, separately per group, was used to examine the correlation between IPAQ and total distance on 6MWT and DWI 6-1. Results: Moderate and total physical activities were significantly moderately associated with the 6MWT (MSWF: rho = 0.598, p<0.003 and rho = 0.608, p<0.003, respectively; NWFMS: rho = 0.564, p<0.008 and rho = 0.628, p<0.002 respectively) and the DWI 6-1 (MSWF: rho = 0.524, p<0.012 and rho = 0.461, p<0.031 respectively; NWFMS: rho = 0.441, p<0.045-moderate). No significant association was observed between moderate and total (HC) and vigorous activities (MS-WF, NWF-MS and HC) with the 6MWT and DWI 6-1. Conclusion: Our results indicate that physical activity is similarly associated with walking capacity and WF. The lower levels of physical activity, normally observed among studies in pwMS, could be related to lower walking capacity (i.e., lower performance on 6MWT) and lower capacity to sustain walking performance over prolonged periods (i.e., lower values on DWI 6-1). Improving walking capacity and fatigability may consequently improve physical activity in pwMS and other factors associated as fatigue, quality of life and disability levels
Prevalence, severity and impact of MS symptoms, and use of services in Europe: results from the large scale IMSS survey
No full textTapping to music and metronome ticks at high and low tempi in persons with progressive MS
No full textPerceived and actual arm performance in multiple sclerosis: relationship with clinical tests according to hand dominance
No full textBACKGROUND: The real-life relevance of frequently applied clinical arm tests is not well known in multiple sclerosis (MS). OBJECTIVE: This study aimed to determine the relation between real-life arm performance and clinical tests in MS. METHODS: Thirty wheelchair-bound MS patients and 30 healthy controls were included. Actual and perceived real-life arm performance was measured by using accelerometry and a self-reported measure (Motor Activity Log). Clinical tests on 'body functions & structures' (JAMAR handgrip strength, Motricity Index (MI), Fugl Meyer (FM)) and 'activity' level (Nine Hole Peg Test (NHPT), Action Research Arm test) of the International Classification of Functioning were conducted. Statistical analyses were performed separately for current dominant and non-dominant arm. RESULTS: For all outcome measures, MS patients scored with both arms significantly lower than the control group. Higher correlations between actual arm performance and clinical tests were found for the non-dominant arm (0.63-0.80). The FM (55%) was a good predictor of actual arm performance, while the MI (46%) and NHPT (55%) were good predictors of perceived arm performance. CONCLUSIONS: Real-life arm performance is decreased in wheelchair-bound MS patients and can be best predicted by measures on 'body functions & structures' level and fine motor control. Hand dominance influenced the magnitude of relationships.sponsorship: Ilse Lamers is supported by a PhD fellowship from the Research council of Hasselt University (BOF-grant). The equipment (accelerometers) were funded by WOMS (Wetenschappelijk Onderzoek in Multiple Sclerosis) and by a Belgian Charcot Foundation equipment grant. (Research council of Hasselt University (BOF-grant), WOMS (Wetenschappelijk Onderzoek in Multiple Sclerosis), Belgian Charcot Foundation)status: Publishe
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