An investigation into the use of 3 Walking related Outcome Measures for Chronic Myelopathy
Adonis, A; Taylor, G.P
Physiotherapy dept, 1st Floor Winston Churchill Wing, St Mary's Hospital, Imperial College Healthcare NHS trust, Praed Street, London W2 1NY
Background: Human T-cell Lymphotrophic Virus Type 1( HTLV 1) Associated Myelopathy (HAM) is a neurological condition of unknown aetiology. These patients suffer lifelong disability, with restriction in their quality of life & activities of daily living. Currently there are ongoing clinical trials requiring a robust, clinically useful tool to measure the effects of any intervention that these patients receive, with meaningful implication for patient function. Thus far no outcome measures are able to routinely detect change in the patient’s condition. Aim: Investigation of 3 walking related outcome measures, the 10 metre timed walk (10mTW); Timed Up and Go(TUAG)& MSWS 12, in HAM patients at 6 time points. Methods: A repeated study design with a single observer, applied the 3 outcome measures to HAM patients who sequentially attended their HTLV outpatient clinic appointments Results: 8 patients completed the study. Good correlation existed for 10mTW vs TUAG (R²-0.99).Increased variability in MSWS 12 scores & poor correlation of TUAG vs MSWS 12 vs 10mTW. None of the outcome measures showed a clinically significant change (p=<0.05)and potential contributing factors include the influence of spasticity & pain levels on physical function. Discussion Robust, clinically useful & sensitive measurement tools for HAM patients need to take into account the varying factors that may influence the patient’s functional ability. Despite TUAG;MSWS 12 & 10mTW not showing clinically significant change in the walking ability, MSWS12 alluded to patient’s perceiving themselves more disabled. Motor components that patients struggle with were unmasked, this can be masked when doing physical assessments on these patients
References
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