Multiple Sclerosis Functional Composite (MSFC): Difference between revisions
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* Calculator | * Calculator | ||
==== Instructions ==== | |||
Tests should be explained to the patient in a clear and understandable way as guided in manual given in resources section. | |||
The testing room settings and environmental conditions should be standardized and any change should be avoided. All equipment (stopwatch, marked 25-foot line, 9HPT apparatus, CD player, PASAT-3 stimulus records, pen and patient forms) should be kept readily available. Any effort should be made to avoid any unnecessary stimulus that could distract the patient. Only the examiner and the patient should be in the testing room during 9HPT and PASAT-3. The space for T25W should be cleared off any obstacles. | |||
The patient should feel comfortable with the situation. Examiner should explain the instructions in a professional but friendly way and let the patient ask any questions before starting the tests. | |||
Examiner should write down the test results, as well as any situation that disturbs the performance of patient. | |||
Examiner should not provide direct feedback to the patient about his/her performance. | |||
{| class="wikitable" | {| class="wikitable" | ||
|+'''Three Functional domains''' | |+'''Three Functional domains''' | ||
|- | |- | ||
|[[Nine-Hole Peg Test]] | |[[Nine-Hole Peg Test]] | ||
|It is a quantitative measure of hand function and is tested with the nine-hole peg test<ref name=":1" />. | |It is a quantitative measure of hand function and is tested with the nine-hole peg test<ref name=":1" />. The patient is instructed to arrange pegs into nine holes in a board by both dominant and non-dominant hands in two consecutive trials for each hand. The amount of time (in seconds) required to place and remove all nine pegs is recorded for each trial<ref name=":2">Tiftikçioğlu B. İ. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278631/ Multiple Sclerosis Functional Composite (MSFC): Scoring Instructions.] 55(Suppl 1), S46–S48. <nowiki>https://doi.org/10.29399/npa.23330</nowiki>. Noro psikiyatri arsivi. 2014;55(1):46–48.</ref>. | ||
The patient is instructed to arrange pegs into nine holes in a board by both dominant and non-dominant hands in two consecutive trials for each hand. | |||
The amount of time (in seconds) required to place and remove all nine pegs is recorded for each trial<ref name=":2">Tiftikçioğlu B. İ. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278631/ Multiple Sclerosis Functional Composite (MSFC): Scoring Instructions.] 55(Suppl 1), S46–S48. <nowiki>https://doi.org/10.29399/npa.23330</nowiki>. Noro psikiyatri arsivi. 2014;55(1):46–48.</ref>. | |||
|- | |- | ||
|Timed 25-foot walk test (T25W) | |Timed 25-foot walk test (T25W) | ||
|The timed 25-foot walk test (T25W) is a quantitative measure of ambulation. The T25W is a reliable test for patients with more severe gait impairment because it primarily assesses walking speed<ref name=":1" />. | |The timed 25-foot walk test (T25W) is a quantitative measure of ambulation. The T25W is a reliable test for patients with more severe gait impairment because it primarily assesses walking speed<ref name=":1" />. The patient is instructed to walk a distance of 25 feet as quickly as possible. Both ends are marked with prominent signs. Note, if the patient requires his/her assistive device while walking. As the patient completes trail 1 he/she is instructed to walk back to the starting point (Trial 2). The time will be recorded in seconds in both trials. Time limit = 180 seconds (3 minutes). Discontinued = Patient is unable to complete a trial in 3 minutes or completes the first trial but cannot complete trial 2 after a 5-minute rest period<ref name=":2" />. | ||
The patient is instructed to walk a distance of 25 feet as quickly as possible. Both ends are marked with prominent signs. Note, if the patient requires his/her assistive device while walking. As the patient completes trail 1 he/she is instructed to walk back to the starting point (Trial 2). The time | |||
Time limit = 180 seconds (3 minutes) | |||
Discontinued = Patient is unable to complete a trial in 3 minutes or completes the first trial but cannot complete trial 2 after a 5-minute rest period<ref name=":2" />. | |||
|- | |- | ||
|(PASAT)Paced auditory serial addition task | |(PASAT)Paced auditory serial addition task | ||
|PASAT was originally included to cover the cognitive domain. It measures processing speed and working memory(concentration, speed of auditory, information processing, flexibility and calculation) in MS patients<ref name=":1" />. | |PASAT was originally included to cover the cognitive domain. It measures processing speed and working memory(concentration, speed of auditory, information processing, flexibility and calculation) in MS patients<ref name=":1" />. A total of sixty single-digit numbers are presented by an audiotape at a constant rate every 3 seconds. The patient is instructed to add each new number to the one immediately before it. | ||
A total of sixty single-digit numbers are presented by an audiotape at a constant rate every 3 seconds. | The patient is allowed up to three practice trials, two of the correct answers on any three trials are sufficient to proceed with the original test. Two sets of numbers have been designed to be used alternatively in every visit to minimize memorizing. The test score (out of 60)is the number of correct sums given<ref name=":2" />. | ||
The patient is instructed to add each new number to the one immediately before it. | |||
The patient is allowed up to three practice trials, two of the correct answers on any three trials are sufficient to proceed with the original test. Two sets of numbers have been designed to be used alternatively in every visit to minimize memorizing. | |||
The test score (out of 60)is the number of correct sums given<ref name=":2" />. | |||
|} | |} | ||
The results of the tests are depicted in an interval scale (seconds or number of correct responses) and can be converted to a ''Z'' score that is based on values of a reference population. An overall score can be calculated by averaging the ''Z'' score of the subtests<ref name=":1" />. | The results of the tests are depicted in an interval scale (seconds or number of correct responses) and can be converted to a ''Z'' score that is based on values of a reference population. An overall score can be calculated by averaging the ''Z'' score of the subtests<ref name=":1" />. | ||
Revision as of 18:13, 3 March 2024
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Purpose[edit | edit source]
The Multiple Sclerosis Functional Composite (MSFC) designed by "National MS Society's Clinical Outcome Assessment Task" and is a standardized tool used to quantify degree of disability in patients with multiple sclerosis (MS)[1]. Limitations in Expanded Disability Status Scale leads to development of MSFC in the early 1990's, to improve clinical assessment of patients with multiple sclerosis[2][3]. The traditional scales such as EDSS scale are inadequate in measuring some key aspects of MS for example cognitive function and have psychometric limitations as well[1].
Technique[edit | edit source]
MSFC covers three functional domains[3]:
- Ambulatory Function
- Hand Function
- Cognitive function
Performed with in 20 minutes.
Required equipment[edit | edit source]
- Measured 25-foot walkway
- 9HPT kit
- PASAT audiotape
- Stopwatch
- Forms to record data
- Calculator
Instructions[edit | edit source]
Tests should be explained to the patient in a clear and understandable way as guided in manual given in resources section.
The testing room settings and environmental conditions should be standardized and any change should be avoided. All equipment (stopwatch, marked 25-foot line, 9HPT apparatus, CD player, PASAT-3 stimulus records, pen and patient forms) should be kept readily available. Any effort should be made to avoid any unnecessary stimulus that could distract the patient. Only the examiner and the patient should be in the testing room during 9HPT and PASAT-3. The space for T25W should be cleared off any obstacles.
The patient should feel comfortable with the situation. Examiner should explain the instructions in a professional but friendly way and let the patient ask any questions before starting the tests.
Examiner should write down the test results, as well as any situation that disturbs the performance of patient.
Examiner should not provide direct feedback to the patient about his/her performance.
| Nine-Hole Peg Test | It is a quantitative measure of hand function and is tested with the nine-hole peg test[3]. The patient is instructed to arrange pegs into nine holes in a board by both dominant and non-dominant hands in two consecutive trials for each hand. The amount of time (in seconds) required to place and remove all nine pegs is recorded for each trial[4]. |
| Timed 25-foot walk test (T25W) | The timed 25-foot walk test (T25W) is a quantitative measure of ambulation. The T25W is a reliable test for patients with more severe gait impairment because it primarily assesses walking speed[3]. The patient is instructed to walk a distance of 25 feet as quickly as possible. Both ends are marked with prominent signs. Note, if the patient requires his/her assistive device while walking. As the patient completes trail 1 he/she is instructed to walk back to the starting point (Trial 2). The time will be recorded in seconds in both trials. Time limit = 180 seconds (3 minutes). Discontinued = Patient is unable to complete a trial in 3 minutes or completes the first trial but cannot complete trial 2 after a 5-minute rest period[4]. |
| (PASAT)Paced auditory serial addition task | PASAT was originally included to cover the cognitive domain. It measures processing speed and working memory(concentration, speed of auditory, information processing, flexibility and calculation) in MS patients[3]. A total of sixty single-digit numbers are presented by an audiotape at a constant rate every 3 seconds. The patient is instructed to add each new number to the one immediately before it.
The patient is allowed up to three practice trials, two of the correct answers on any three trials are sufficient to proceed with the original test. Two sets of numbers have been designed to be used alternatively in every visit to minimize memorizing. The test score (out of 60)is the number of correct sums given[4]. |
The results of the tests are depicted in an interval scale (seconds or number of correct responses) and can be converted to a Z score that is based on values of a reference population. An overall score can be calculated by averaging the Z score of the subtests[3].
Evidence[edit | edit source]
It has good intra- and inter-rater reliability and it results in a score on a continuous scale[3].
Excellent test-retest reliability (ICC = 0.96)[5]
Resources[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 JS, RA, GR, SC. F Rudick, Cutter, Reingold. The Multiple Sclerosis Functional Composite measure (MSFC): an integrated approach to MS clinical outcome assessment. Multiple Sclerosis Journal [Internet]. 1999 [cited 2024 Mar 1];5(4):244–250.
- ↑ Cutter GR, Baier ML, Rudick RA, Cookfair DL, Fischer JS, Petkau J, . Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain [Internet]. 1999 [cited 2024 Mar 1];122(5):871–882.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Van Munster, C. E., & Uitdehaag, B. M. Outcome Measures in Clinical Trials for Multiple Sclerosis. CNS drugs. 2017;31(3):217–236.
- ↑ 4.0 4.1 4.2 Tiftikçioğlu B. İ. Multiple Sclerosis Functional Composite (MSFC): Scoring Instructions. 55(Suppl 1), S46–S48. https://doi.org/10.29399/npa.23330. Noro psikiyatri arsivi. 2014;55(1):46–48.
- ↑ Cohen, J. A., Fischer, J. S., et al. . “Intrarater and interrater reliability of the MS functional composite outcome measure.” 54(4): 802-806. Neurology [Internet]. 1994;54(4):802–806. Available from: https://pubmed.ncbi.nlm.nih.gov/10690966/
