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MacKenzie EG, Snow NJ, Chaves AR, Reza SZ, Ploughman M. Weak grip strength among persons with multiple sclerosis having minimal disability is not related to agility or integrity of the corticospinal tract. Mult Scler Relat Disord 2024; 88:105741. [PMID: 38936325 DOI: 10.1016/j.msard.2024.105741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/23/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
INTRODUCTION Mobility impairment is common in multiple sclerosis (MS); however, agility has received less attention. Agility requires strength and neuromuscular coordination to elicit controlled propulsive rapid whole-body movement. Grip strength is a common method to assess whole body force production, but also reflects neuromuscular integrity and global brain health. Impaired agility may be linked to loss of neuromuscular integrity (reflected by grip strength or corticospinal excitability). OBJECTIVES We aimed to determine whether grip strength would be associated with agility and transcranial magnetic stimulation (TMS)-based indices of corticospinal excitability and inhibition in persons with MS having low disability. We hypothesized that low grip strength would predict impaired agility and reflect low corticospinal excitability. METHODS We recruited 34 persons with relapsing MS (27 females; median [range] age 45.5 [21.0-65.0] years) and mild disability (median [range] Expanded Disability Status Scale 2.0 [0-3.0]), as well as a convenience sample of age- and sex-matched apparently healthy controls. Agility was tested by measuring hop length during bipedal hopping on an instrumented walkway. Grip strength was measured using a calibrated dynamometer. Corticospinal excitability and inhibition were examined using TMS-based motor evoked potential (MEP) and corticospinal silent period (CSP) recruitment curves, respectively. RESULTS MS participants had significantly lower grip strength than controls independent of sex. Females with and without MS had weaker grip strength than males. There were no statistically significant sex or group differences in agility. After controlling for sex, weaker grip strength was associated with shorter hop length in controls only (r = 0.645, p < .05). Grip strength did not significantly predict agility in persons with MS, nor was grip strength predicted by corticospinal excitability or inhibition. CONCLUSIONS In persons with MS having low disability, grip strength (normalized to body mass) was reduced despite having intact agility and walking performance. Grip strength was not associated with corticospinal excitability or inhibition, suggesting peripheral neuromuscular function, low physical activity or fitness, or other psychosocial factors may be related to weakness. Low grip strength is a putative indicator of early neuromuscular aging in persons with MS having mild disability and normal mobility.
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Affiliation(s)
- Evan G MacKenzie
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada
| | - Nicholas J Snow
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada
| | - Arthur R Chaves
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, ON, Canada; Neuromodulation Research Clinic, The Royal's Institute of Mental Health Research, ON, Canada; Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, QC, Canada
| | - Syed Z Reza
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada
| | - Michelle Ploughman
- Faculty of Medicine, Recovery & Performance Laboratory, Memorial University of Newfoundland and Labrador, Room 400, L.A. Miller Center, 100 Forest Road, St. John's, St. John's, NL A1A 1E5, Canada.
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Albishi AM, Alruwaili MB, Alsubiheen AM, Alnahdi AH, Alokaily AO, Algabbani MF, Alrahed Alhumaid LA, Alderaa AA, Aljarallah S. Cross-cultural adaptation and validation of the Arabic version of the Multiple Sclerosis Impact Scale-29. Disabil Rehabil 2024:1-8. [PMID: 38738778 DOI: 10.1080/09638288.2024.2350618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE The Multiple Sclerosis Impact Scale-29 (MSIS-29) is a patient self-reported outcome (PRO) that measures patients' quality of life, and it is divided into two sub-scales for the physical (PHYS) and psychological (PSYCH) domains. This study aimed to translate the MSIS-29 into Arabic, cross-culturally adapt it, and examine its psychometric properties. MATERIALS AND METHODS One hundred fifty patients with MS completed the MSIS-29-Ar, the Functional Assessment of Multiple Sclerosis (FAMS), and the Short-Form Health Survey (SF-36). After one week, 60 participants were asked to complete the MSIS-29-Ar again to examine test-retest reliability. RESULTS The MSIS-29-Ar was clear and understandable among patients with MS in Saudi Arabia. The internal consistency for the MSIS-29-Ar-PHYS was excellent, with a Cronbach's alpha of 0.955, and was good for the MSIS-29-Ar-PSYCH, with a Cronbach's alpha of 0.891. The test-retest reliability for MSIS-29-Ar-PHYS was ICC2,1 = 0.97; 95% confidence interval (0.93, 0.99) and ICC2,1 = 0.95.; 95% confidence interval (0.897, 0.976) for MSIS-29-Ar-PSYCH domains. The minimal detectable change with 95% confidence (MDC95) was 10.28 and 13.37 for the MSIS-29-Ar-PHYS and MSIS-29-Ar-PSYCH, respectively. No floor and ceiling effects were observed. Convergent and divergent validity was supported by 75% of the predefined hypotheses and correlated with the other health-related quality-of-life measures, SF-36 and FAMS. CONCLUSION The MSIS-29-Ar questionnaire is a valid and reliable outcome measure among Saudi patients with MS.IMPLICATION FOR REHABILITATIONRehabilitation specialists can confidently interpret patient scores in the MSIS-29-Ar to measure physical and psychological factors impacting patients' quality of life with Multiple Sclerosis (MS).Patients with unchanged clinical status will have similar scores in the MSIS-29-Ar with repeated scale administrations over time.The MSIS-29-Ar can be used in clinical practice and research studies to measure factors that impact the quality of life in Arabic-speaking patients with MS.
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Affiliation(s)
- Alaa M Albishi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Malak B Alruwaili
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman M Alsubiheen
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali H Alnahdi
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad O Alokaily
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Maha F Algabbani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Lolwah A Alrahed Alhumaid
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Asma A Alderaa
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Salman Aljarallah
- Department of Medicine, Neurology section, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Blázquez-Fernández A, López-Hazas-Jiménez G, Fernández-Vázquez D, Navarro-López V, Fernández-González P, Marcos-Antón S, Molina-Rueda F, Cano-de-la-Cuerda R. Effects of the powerball® system on muscle strength, coordination, fatigue, functionality and quality of life in people with multiple sclerosis. A randomized clinical trial. J Neuroeng Rehabil 2024; 21:33. [PMID: 38431591 PMCID: PMC10908022 DOI: 10.1186/s12984-024-01325-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Although clinical and functional impairments in the lower limbs have been extensively studied in patients with MS, the upper limb (UL) are also frequently affected. Clinical impairment of the UL in patients with MS is very common with muscle strength and hand dexterity as critical factors in maintaining functional activities that are the basis for independence and quality of life in people with MS. OBJECTIVE To investigate the effects of a training protocol using the Powerball® system in combination with conventional physiotherapy on muscle strength, coordination, fatigue, functionality, and quality of life in persons with MS over an 8-week period. MATERIALS AND METHODS A double-blind randomized controlled trial was conducted. The control group received conventional treatment, while the experimental group received additional UL training using the Powerball® system. Both groups received the same number of sessions and weeks of intervention. The following outcome measures were used: isometric grip and pinch strength, Box and Block Test (BBT), Nine Hole Peg Test (NHPT), Abilhand scale, Fatigue Severity Scale (FSS), Multiple Sclerosis Impact Scale (MSIS-29), and Likert satisfaction questionnaire for the experimental group. All measures were administered at baseline, after the treatment, and during a 3-week follow-up period. RESULTS 25 patients completed the study (12 in the experimental and 13 in the control group). The experimental group showed significant improvements in coordination and manual dexterity of the more affected UL as measured by the BBT comparing pre- to post-treatment (p = 0.048) and pre-treatment to follow-up (p = 0.001), and on the less affected UP comparing pre-treatment to follow-up (p < 0.001) and post-treatment to follow-up (p = 0.034). The Likert-type satisfaction questionnaire obtained a mean score of 89.10 (± 8.54) out of 100 points. CONCLUSIONS Upper limb treatment protocol using the Powerball® system, in combination with conventional physiotherapy for 8 weeks resulted in significant improvements in the intra-group analysis for UL coordination and manual dexterity in favor of the experimental group. The experimental group showed excellent satisfaction to the treatment.
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Affiliation(s)
| | | | - Diego Fernández-Vázquez
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
| | - Víctor Navarro-López
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Pilar Fernández-González
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
| | - Selena Marcos-Antón
- Multiple Sclerosis Association of Leganés. Leganés, Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Francisco Molina-Rueda
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain
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Bahrami F, Pour FJ, Hassanpour M, Saki M, Ebrahimzadeh F, Jafaripour L. The effect of saffron and corrective exercises on depression and quality of life in women with multiple sclerosis: A randomized controlled clinical trial. Mult Scler Relat Disord 2023; 79:105038. [PMID: 37801956 DOI: 10.1016/j.msard.2023.105038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/07/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023]
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system which causes various complications such as reduced ability to do daily activities, depression and early death of patients. The present study aimed to compare the effect of saffron and corrective exercises on depression and quality of life in women with MS. This randomized controlled clinical trial was conducted on 80 MS women for 12 weeks. Participants were selected through convenience sampling and allocated into four study groups (three intervention groups and one control group) using the stratified block randomization. The Expanded Disability Status Scale, Beck Depression Inventory and The Multiple Sclerosis Impact Scale were used to collect data at the start of the study and also at the end of the sixth and the twelfth weeks. At the end of the twelfth week, the depression mean scores in all experimental groups (saffron group, corrective exercises group, corrective exercises + saffron group) were significantly different compared to the control group (P < 0.05), and this difference in corrective exercises + saffron group was more than the others. Also, at the end of the twelfth week, the mean scores of the quality of life (both physical and mental dimensions) in all experimental groups were significantly different from the control group (P < 0.05). The saffron group in physical dimension and the corrective exercises + saffron group in psychological dimension showed a significant difference with other groups. Although each of the corrective exercises program and saffron consumption alone were effective in reducing depression and enhancing the quality of life in MS patients, the consequences will be more beneficial in case these two interventions are used together. Therefore, it is necessary to encourage MS patients to consume saffron supplement along with doing physical activities in caring and rehabilitation programs.
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Affiliation(s)
- Farid Bahrami
- PhD in Sports Physiology, Lorestan University, Khorramabad, Iran
| | | | | | - Mandana Saki
- PhD in Nursing, Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Iran; Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Farzad Ebrahimzadeh
- PhD in Biostatistics, Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Leila Jafaripour
- Department of Anatomy, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
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Jerković A, Nikolić Ivanišević M, Šimić N, Poljičanin A, Đogaš Z, Rogić Vidaković M. Psychometric properties of the Croatian version of the Multiple Sclerosis Walking Scale (MSWS-12). Disabil Rehabil 2023; 45:3373-3378. [PMID: 36222552 DOI: 10.1080/09638288.2022.2132301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Walking difficulties in people with multiple sclerosis (pwMS) are one of the most pronounced predictors affecting patients' quality of life. The study objective was to determine the psychometric properties of the Croatian version of the Multiple Sclerosis Walking Scale (MSWS-12) among pwMS in Croatia and to examine the association between MSWS-12 and Depression, Anxiety, and Stress Scale-21 (DASS-21), and Multiple Sclerosis Impact Scale-29 (MSIS-29). MATERIALS AND METHODS A cross-sectional study included a sample of pwMS (N = 148). Psychometric properties were examined by estimating the validity and reliability of the MSWS-12. The predictive validity of MSWS-12 and demographic and disease-related factors were assessed by a hierarchical regression model using MSIS-29 and DASS-21 as criterion variables. RESULTS Scale reliability was good for the MSWS-12 scale, expressed by Cronbach's alpha coefficient (α = 0.98). Correlations between MSWS-12 and DASS-21 (0.20-0.27) and between MSWS-12 and MSIS-29 subscales (0.47-0.83) provided initial support for the convergent validity. Factor analysis demonstrated the unidimensional structure of the MSWS-12. CONCLUSIONS The Croatian version of the MSWS-12 is a reliable, valid, and clinically useful tool for assessing walking impairments in pwMS.Implications for rehabilitationWalking difficulties in people with multiple sclerosis (pwMS) are one of the most pronounced predictors affecting patients' quality of life.Multiple Sclerosis Walking Scale (MSWS-12) is a measure of the disease's impact on walking abilities from the patient's perspective.MSWS-12 is a reliable scale for assessing walking speed, endurance, and gait quality in multiple sclerosis and is validated in several languages (Korean, Italian, Brazilian, and Persian).The Croatian version of the MSWS-12 is a reliable, predictive, and valid tool for screening walking impairments in pwMS.
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Affiliation(s)
- Ana Jerković
- Department of Neuroscience, School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split, Split, Croatia
| | | | - Nataša Šimić
- Department of Psychology, University of Zadar, Zadar, Croatia
| | - Ana Poljičanin
- Institute of Physical Medicine and Rehabilitation with Rheumatology, University Hospital of Split, Split, Croatia
- Department of Health Studies, University of Split, Split, Croatia
| | - Zoran Đogaš
- Department of Neuroscience, School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split, Split, Croatia
- Sleep Medical Centre, University Hospital of Split, Split, Croatia
| | - Maja Rogić Vidaković
- Department of Neuroscience, School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), University of Split, Split, Croatia
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Radecka A, Knyszyńska A, Łuczak J, Lubkowska A. Adaptive changes in muscle activity after cryotherapy treatment: Potential mechanism for improvement the functional state in patients with multiple sclerosis. NeuroRehabilitation 2021; 48:119-131. [PMID: 33386821 DOI: 10.3233/nre-201535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The available literature lacks data about the influence of whole body cryotherapy (WBC) on muscle activity in patients with sclerosis multiplex (MS). OBJECTIVE Assessment of the influence of the 20 WBC series on the surface electromyography (sEMG) signal and the relationship between it and the functional state in patients with MS. METHODS The study group was 114 of MS patients (aged 45.24±11.88yr.,) which 74 of them received 20 of WBC. An assessment was made of: the hand grip (HGS), Timed 25-Foot Walk, Fatigue Severity Scale, sEMG signal from the dominant limb. RESULTS After a series of 20 WBC: in the rest electromyograms, an increase of extensor carpi radialis (ECR) and a decrease of flexor carpi radialis (FCR) amplitude were demonstrated (non-normalized signal ECR p = 0.0001); significant differences in sEMG rest signals between ECR and FCR have decreased; for voluntary contraction in both assessed antagonistic muscle amplitude was significantly decreased (p = 0.0005; p = 0.0316, p = 0.0185); an increase of HGS (p < 0.001); gait improvement (p = 0.001); decrease fatigue (p = 0.024). No significant changes were observed in the control group. CONCLUSIONS Series of 20 WBC improves the functional state and reduces fatigue in patients with MS, which may be due to adaptive changes in bioelectrical muscle activity.
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Affiliation(s)
- Aleksandra Radecka
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anna Knyszyńska
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Joanna Łuczak
- College of Engineering and Health in Warsaw, Faculty of Health Sciences, Warsaw, Poland.,Department of Cardiological Rehabilitation, Central Clinical Hospital of the Ministry of Internal Affairs and Administration in Warsaw, Warsaw, Poland
| | - Anna Lubkowska
- Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Rogić Vidaković M, Šimić N, Poljičanin A, Nikolić Ivanišević M, Ana J, Đogaš Z. Psychometric properties of the Croatian version of the depression, anxiety, and stress scale-21 and multiple sclerosis impact scale-29 in multiple sclerosis patients. Mult Scler Relat Disord 2021; 50:102850. [PMID: 33636617 DOI: 10.1016/j.msard.2021.102850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/05/2021] [Accepted: 02/18/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Depression, anxiety, stress, and physical disabilities are a common complaint in people with multiple sclerosis (MS), and monitoring of these symptoms are based on self-report questionnaires. The objective of this study was to determine psychometric properties of the Croatian version of the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Multiple Sclerosis Impact Scale-29 (MSIS-29) in people with MS. MATERIALS AND METHODS We included data on 163 people with MS registered in the Association of multiple sclerosis societies of Croatia (AMSSC). Patients' demographic information, education level, and disease-related variables were ascertained. DASS-21 was applied for assessing depression, anxiety, and stress, while MSIS-29 scale was used for assessment of the physical and psychological impact of MS disease. Psychometric properties were examined by estimating the validity and reliability of the DASS-21 and MSIS-29 scale. Predictive validity of DASS-21 subscales and relevant demographic and disease-related variables was examined by the hierarchical regression model. RESULTS The Croatian version of the three DASS-21 subscales and two MSIS-29 subscales had excellent internal consistencies (Cronbach's alpha coefficients 0.88-0.93) and good convergent validity, as expressed by inter-correlations between DASS-21 and MSIS-29 subscales. Hierarchical regression analysis using MSIS-29 subscales as criterion variables showed consistent evidence for the predictive validity of depression, anxiety, and stress on psychological impact, and predictive validity of age, EDSS, and anxiety on physical impact. CONCLUSIONS The Croatian versions of DASS-21 and MSIS-29 are reliable and valid scales in people with MS.
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Affiliation(s)
- Maja Rogić Vidaković
- University of Split, School of Medicine, Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), Split, Croatia.
| | - Nataša Šimić
- University of Zadar, Department of Psychology, Zadar, Croatia
| | - Ana Poljičanin
- Clinical Hospital Split, Institute of Physical Medicine and Rehabilitation with Rheumatology, Split, Croatia; University of Split, Department of Health Studies, Split, Croatia
| | | | - Jerković Ana
- University of Split, School of Medicine, Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), Split, Croatia
| | - Zoran Đogaš
- University of Split, School of Medicine, Department of Neuroscience, Laboratory for Human and Experimental Neurophysiology (LAHEN), Split, Croatia; Split Sleep Medical Center, University of Split, Split, Croatia
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Purmonen T, Hakkarainen T, Tervomaa M, Ruutiainen J. Impact of multiple sclerosis phenotypes on burden of disease in Finland. J Med Econ 2020; 23:156-165. [PMID: 31617776 DOI: 10.1080/13696998.2019.1682004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aims: The aim of this study was to quantify how multiple sclerosis (MS) phenotypes differ from each other in respect of costs and quality-of-life.Materials and methods: The study is based on survey data from Finnish patients with MS (n = 553). The information contained disease type, disease severity according to self-reported Expanded Disease Severity Scale (EDSS), healthcare resource use, and medication use. In addition, information related to employment and early retirement was collected. EQ-5D-VAS and Multiple Sclerosis Impact Scale-29 (MSIS-29) instruments were used to collect quality-of-life data, and Fatigue Severity Scale (FSS) instrument for evaluating fatigue. Patients were stratified based on their disease type (relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS)) and disease severity. The data were primarily analyzed using summary statistics.Results: SPMS had the highest annual total cost (71,177€) followed by PPMS (51,082€) and RRMS (36,492€). Early retirement covered the greatest share of costs in RRMS (39%) and SPMS (43%). In PPMS, early retirement and professional care were the two most equally important cost drivers, contributing together 56% of the total costs. Direct healthcare costs were responsible for 33%, 19%, and 18% of total costs in RRMS, SPMS, and PPMS. The mean EDSS in RRMS, SPMS, and PPMS were 2.5, 5.5, and 5.9, respectively. Differences in the quality-of-life were observed with both disease specific (MSIS-29) and generic (EQ-5D-VAS) instruments. The mean utility value from EQ-5D among patients with RRMS, SPMS, and PPMS was 0.76, 0.52, and 0.49, respectively. In addition, patients with SPMS and PPMS were more likely to report fatigue than patients with RRMS.Conclusions: MS phenotype has an impact on costs and quality-of-life of the patients. Early retirement seems to be one of the most important contributors to MS-related costs.
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Affiliation(s)
| | | | | | - Juhani Ruutiainen
- Finnish Neuro Society, Masku, Finland
- Department of Neurology, University of Turku, Turku, Finland
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Laakso SM, Viitala M, Kuusisto H, Sarasoja T, Hartikainen P, Atula S, Tienari PJ, Soilu‐Hänninen M. Multiple sclerosis in Finland 2018-Data from the national register. Acta Neurol Scand 2019; 140:303-311. [PMID: 31271648 DOI: 10.1111/ane.13145] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 06/20/2019] [Accepted: 06/30/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Finland is a high-risk multiple sclerosis (MS) region, but a national MS register has not existed until 2014. In this paper, we present the Finnish MS register variables and data collected by 31 December 2018. MATERIALS AND METHODS Numbers and data counts of MS patients in the register (ICD-10 code G35) are presented. The disease types and proportion of patients receiving disease-modifying treatments (DMTs) were analysed in five hospital districts with most complete data sets. MS prevalence in Finland was estimated using administrative hospital discharge data as an additional resource. RESULTS There were a total of 8722 MS patients in the Finnish MS register by 31 December 2018 (71.5% females). Mean age at MS diagnosis was 38.7 years and peak prevalence was at age 50-54 years. Disease course was relapsing remitting (RRMS) in 66.7%, secondary progressive (SPMS) in 13.5%, and primary progressive (PPMS) in 7.9% of the 5365 MS patients in the selected districts with most complete data. A total of 66.0% of RRMS patients, 19.6% of SPMS patients and 9.9% of PPMS patients were receiving DMTs. By combining MS register data with databases of those hospitals that had not joined the register, the nationwide prevalence estimate was between 10 and 11 thousand patients (corresponding to crude prevalence 180-200/100 000). CONCLUSIONS The Finnish MS register is currently used in 15/21 Finnish hospital districts. By register integration into the electronic patient files, the coverage of the register has increased to approximately 80% of the estimated Finnish MS population.
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Affiliation(s)
- Sini M. Laakso
- Neurocenter Helsinki University Hospital Helsinki Finland
- Department of Neurosciences University of Helsinki Helsinki Finland
| | - Matias Viitala
- Department of Mathematics and Statistics University of Turku Turku Finland
- StellarQ Ltd Turku Finland
| | - Hanna Kuusisto
- Department of Neurology Tampere University Hospital Tampere Finland
- Department of Health and Social management University of Eastern Finland Kuopio Finland
| | - Taneli Sarasoja
- Department of Neurology Central Hospital of Central Finland Jyväskylä Finland
| | - Päivi Hartikainen
- Department of Neurology Kuopio University Hospital Kuopio Finland
- Department of Neurology University of Eastern Finland Kuopio Finland
| | - Sari Atula
- Neurocenter Helsinki University Hospital Helsinki Finland
- Department of Neurosciences University of Helsinki Helsinki Finland
| | - Pentti J. Tienari
- Neurocenter Helsinki University Hospital Helsinki Finland
- Department of Neurosciences University of Helsinki Helsinki Finland
| | - Merja Soilu‐Hänninen
- Division of Clinical Neurosciences Turku University Hospital Turku Finland
- Department of Neurology University of Turku Turku Finland
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PERSECHINO B, FONTANA L, BURESTI G, FORTUNA G, VALENTI A, IAVICOLI S. Improving the job-retention strategies in multiple sclerosis workers: the role of occupational physicians. INDUSTRIAL HEALTH 2019; 57:52-69. [PMID: 30249932 PMCID: PMC6363588 DOI: 10.2486/indhealth.2017-0214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
Several studies evaluated whether a person with multiple sclerosis is employed or not and investigated the main symptoms that hinder the job performance. However, despite occupational physicians are fundamental in managing disabled subjects, there is a serious lack of data regarding their role in improving employability of these workers. In this regard, we assessed occupational physicians' professional activity and training/updating needs in order to identify and develop management tools, operative procedures and training programs helpful to support and implement adequate job-retention strategies. Four hundred three Italian occupational physicians compiled a self-administered questionnaire to evaluate individual demographics, health surveillance system, fitness for work and training needs. Our findings confirmed the suitability to adopt environmental adjustments at workplace (particularly referring to the ergonomics of workstation, the typology of occupational risk factors and the working time) to accommodate individual's needs in order to improve working ability among multiple sclerosis workers. Moreover, training events discussing operational guidelines and standardized instruments and/or methodologies to adequately manage the disable workers should be fostered. Therefore, in this regard, occupational physicians could play a key role but they need more high-quality training especially concerning the different tools that are currently available to assess the work issues in multiple sclerosis patients.
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Affiliation(s)
- Benedetta PERSECHINO
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Luca FONTANA
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Giuliana BURESTI
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Grazia FORTUNA
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Antonio VALENTI
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
| | - Sergio IAVICOLI
- Department of Occupational and Environmental Medicine,
Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Italy
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Öztürk EA, Gönenli Koçer B, Umay E, Çakcı A. Turkish version of Parkinson Fatigue Scale: Validity and reliability study of binary scoring method. Turk J Phys Med Rehabil 2018; 64:253-260. [PMID: 31453519 PMCID: PMC6657793 DOI: 10.5606/tftrd.2018.2074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/17/2017] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The aim of the present study was to translate and cross-culturally adapt the Parkinson Fatigue Scale (PFS) into Turkish and to evaluate its reliability and validity. PATIENTS AND METHODS Between September 2015 and May 2016, a total of 138 patients (84 males, 54 females; mean age 62.8±9.3 years; range, 42 to 83 years) with Parkinson's disease (PD) were included in this study. The Turkish version of the PFS was analyzed for data quality, scaling assumptions, acceptability, reliability, and validity. We used the binary scoring method of the Parkinson Fatigue Scale. RESULTS The data quality for the Turkish version of the PFS was excellent. The scaling assumption was acceptable. The scale provided an acceptable internal consistency (Cronbach's alpha was 0.955 for a test and 0.941 for a retest, and corrected item-to-total correlations were ranged from 0.478 to 0.849. The test-retest reliability (correlation coefficients were ranged from 0.650 to 0.875) was adequate. Although the total binary score of the PFS was not associated with demographic and clinical data, it was significantly correlated with some of the clinical rating scale scores, including the Unified Parkinson's Disease Rating Scale, Schwab & England Activities of Daily Living Scale, Hospital Anxiety and Depression Scale, Epworth Sleepiness Scale, Pittsburg Sleep Quality Index, 36-item Short Form Health Survey, 39-item Parkinson's Disease Questionnaire, and Fatigue Severity Scale. CONCLUSION The Turkish version of the PFS is an acceptable, valid, and reliable tool for the assessment of fatigue in PD patients.
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Affiliation(s)
- Erhan Arif Öztürk
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Bilge Gönenli Koçer
- Department of Neurology, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ebru Umay
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Aytül Çakcı
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Ozturk EA, Kocer BG, Umay E, Cakci A. Cross-cultural adaptation and psychometric evaluations of the Turkish version of Parkinson Fatigue Scale. Qual Life Res 2018; 27:2719-2730. [DOI: 10.1007/s11136-018-1907-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 12/01/2022]
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Rosti-Otajärvi E, Hämäläinen P, Wiksten A, Hakkarainen T, Ruutiainen J. Validity and reliability of the Finnish version of the Multiple Sclerosis Impact Scale-29. Brain Behav 2017; 7:e00725. [PMID: 28729932 PMCID: PMC5516600 DOI: 10.1002/brb3.725] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/29/2017] [Accepted: 04/06/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The Multiple Sclerosis Impact Scale-29 (MSIS-29) has been increasingly used to evaluate the self-perceived impact of multiple sclerosis (MS) on a patient. OBJECTIVES The aim of this study was to evaluate the psychometric properties of the Finnish version of MSIS-29 in patients with MS. METHODS A total of 553 patients with MS completed the MSIS-29 and self-administered questionnaires capturing information on demographics, disease characteristics and severity, perceived quality of life (EuroQol 5D-3L instrument), and fatigue (Fatigue Severity Scale). RESULTS The data quality for MSIS-29 was excellent, with 99.5% computable scores for the MSIS-29 physical scale and 99.3% for the MSIS-29 psychological scale. Floor and ceiling effects were minimal. Excellent Cronbach's alpha values of 0.97 and 0.90 were seen for MSIS-29 physical and psychological subscales, respectively. The physical subscale showed highest correlations with measures of physical functioning, such as disease severity and the mobility domain of the quality of life. Similarly, the psychological subscale showed highest correlations with self-reported fatigue and the anxiety/depression domains of the quality of life. MSIS-29 physical scores related strongly to disease severity, whereas the MSIS-29 psychological scores increased in mild disease but declined in more severe disease forms. CONCLUSION The Finnish version of MSIS-29 has satisfactory psychometric properties. Consistent with the previous recommendations, the use of two MSIS-29 subscale scores instead of a total score was supported.
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Affiliation(s)
- Eija Rosti-Otajärvi
- Department of Neurosciences and Rehabilitation Tampere University Hospital Tampere Finland
| | | | | | | | - Juhani Ruutiainen
- Finnish Neuro Society Masku Finland.,University of Turku Turku Finland
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Rosti-Otajärvi E, Hämäläinen P, Wiksten A, Hakkarainen T, Ruutiainen J. Validity and reliability of the Fatigue Severity Scale in Finnish multiple sclerosis patients. Brain Behav 2017; 7:e00743. [PMID: 28729945 PMCID: PMC5516613 DOI: 10.1002/brb3.743] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/25/2017] [Accepted: 04/29/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Fatigue is one of the most debilitating symptoms in multiple sclerosis (MS) considerably interfering with patients' daily functioning. Both researchers and clinicians need psychometrically robust methods to evaluate fatigue in MS. OBJECTIVES The objective of this study was (i) to evaluate the psychometric properties of the Finnish version of the Fatigue Severity Scale (FSS) and (ii) to describe the results among patients with MS. METHODS In total, 553 patients with MS (mean age, 53.8 years; standard deviation [SD], 11.4; 79% women: mean patient-defined disease severity, Expanded Disability Status Scale [EDSS] 4.0, SD, 2.5) completed the self-administered questionnaires including the FSS. A standard procedure was used for the translation of the FSS. RESULTS The mean (SD) score for the FSS was 4.5 (1.7); in 65% of the patients, the score was ≥4.0. The data quality of the FSS was excellent, with 99.6% of computable scale scores. Floor and ceiling effects were minimal. The FSS showed high internal consistency (Cronbach's alpha, 0.95). Unidimensionality was supported based on confirmatory factor analysis with the comparative fit index being 0.94. The FSS showed moderate/high correlations with the perceived burden of the disease, quality of life and disease severity, whereas, age or gender did not have a significant effect on the FSS score. CONCLUSIONS The Finnish version of the FSS showed satisfactory reliability and validity and thus can be regarded as a feasible measure of self-reported fatigue.
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Affiliation(s)
- Eija Rosti-Otajärvi
- Department of Neurosciences and Rehabilitation Tampere University Hospital Tampere Finland
| | | | | | | | - Juhani Ruutiainen
- Finnish Neuro Society Masku Finland.,University of Turku Turku Finland
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