Multiple Sclerosis (MS)

Tests:

Modified Fatigue Impact Scale (MFIS)

Modified Fatigue Impact Scale (MFIS) is based on items derived from interviews with MS patients concerning how fatigue impacts their lives. This instrument provides an assessment of the effects of fatigue in terms of physical, cognitive, and psychosocial functioning.

The MFIS is a 21-item shortened version of the 40-item FIS and has been recommended for use by the Multiple Sclerosis Counsil for Clinical Practice Guidelines. It assesses the perceived impact of fatigue on the subscales physical, cognitive and psychosocial functioning during the past 4 weeks.

Participants rate their agreement with 21 statements on a 5-point Likert scale, from 0="never" to 4="almost always".

Timed up and go (TUG)

Timed up and go test (TUGT, TUG) is used to determine fall risk and measure the progress of balance, sit to stand and walking. How to perform it:

The patient starts in a seated position. They can wear their regular footwear and use a walking aid, if needed. The patient stands up upon therapist's command: walks 3 meters, turns around, walks back to the chair and sits down. The time stops when the patient is seated. Be sure to document the assistive device used. A practical trial should be completed before the timed trial.

10MWT

10 Meter walk test (10MWT) is a performance measure used to assess walking or gait speed in meters per second over a short distance. It can be employed to determine functional mobility, gait, and vestibular function. Furthermore, gait speed is a strong indicator of overall health and independence in older adults.

Mini Balance Evaluation System Test (Mini-BEST)

Mini balance evaluation system test (mini-BEST) is a clinical balance evaluation to identify balance problems and fall risk, especially in patients with neurological conditions like Parkinson's, stroke and vestibular conditions. It's a shorter version of the BEST and focus on dynamic balance.

Content:

1. Anticipatory postural adjustments

Sit to stand

Rise to toes

Stand on one leg

1. Reactive postural control

Compensatory stepping correction - forward

Compensatory stepping correction - backward

Compensatory stepping correction - lateral

1. Sensory orientation

Stance with feet together, eyes open, firm surface

Stance on foam surface, eyes closed

Incline - eyes closed

1. Dynamic gait

Change in gait speed

Walk with horizontal head turns

Walk with pivot turns

Step over obstacles

Timed up and go with dual task

 

5TSTS

5 times sit to stand (5TSTS) is used to assess functional lower limbs strength, transitional movements, balance, and fall risk in older adults. In older adults, this test is used to assess:

Lower extremity strength

Dynamic balance

Fall risk

Gait speed

The test is based on the amount of time (to the nearest decimal in seconds) a patient is able to transfer from a seated to a standing position and back to sitting five times. The patient is instructed to fold their arms across their chest. Then instructed to do sit-to-stand five times, as quickly as possible.

Ataxia Tests (Romberg)

1. The patients is asked to remove his shoes and stand with his two feet together. The arms are held next to the body or crossed in front of the body.

2. The clinician asks the patient to first stand quietly with eyes open, and subsequently with eyes closed. The patient tries to maintain his balance. For safety, the observer must stand close to the patient to prevent potential injury if the patient were to fall. When the patient closes his eyes, he should not orient himself by light, sense, or sound, as this could influence the test result and cause a false positive outcome.

3. The Romberg test is scored by counting the seconds the patient can stand with eyes closed.

Modified Ashworth Scale (MAS)

The Modified Ashworth scale (MAS) is used to assess spasticity. The test is performed by extending the patients limb's first from a position of maximal possible flexion to maximal possible extension (the point at which the first soft resistance is met). Afterwards, the modified Ashworth scale is assessed while moving from extension to flexion