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Self-perceived physical functioning and health status among fully ambulatory multiple sclerosis patients

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Abstract

We investigated the self-perceived health status among multiple sclerosis (MS) patients with no or mild disability according to the Expanded Disability Status Scale (EDSS) and the impact of self-rated physical functioning. A sample of fully ambulatory (EDSS ≤ 3.5) consecutive patients with MS was included after screening for major cognitive impairment. The EDSS was used to measure nervous system signs or disability, and the self-rated health status was assessed using the SF-36 Health Survey. The normative SF-36 data for the general population of Italy were used for comparison. The 197 MS patients analyzed (150 women and 47 men) had significantly lower mean SF-36 scores than the general population, except for bodily pain. The scores did not differ significantly by gender. The same analysis performed on a subsample of 105 patients (79 women and 26 men) with minimal disability in one functional system (EDSS ≤ 2.0) yielded similar results. EDSS was weakly correlated with the physical functioning subscale and explained only 2% of the variance in the physical functioning subscale. The regression of the physical functioning subscale on the other seven SF-36 subscales was significantly lower among MS patients than in the general population for all subscales, except for role limitation due to physical health problems and social functioning. Neither disease course nor duration correlated significantly with SF-36 subscales. The SF-36 physical functioning subscale seemed to indicate physical functioning more sensitively than EDSS. These findings should encourage the implementation of specific strategies aimed at improving the quality of the self-perceived health status already in the early disease stage.

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References

  1. Apolone G, Cifani S, Mosconi P (1997) Questionario sullo stato di salute SF- 36. Traduzione e validazione della versione italiana: Risultati del progetto IQOLA. Medic 2:86–94

    Google Scholar 

  2. Apolone G, Mosconi P (1998) The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol 51:1025–1036

    Article  PubMed  CAS  Google Scholar 

  3. Arnett PA, Higginson CI, Voss WD, Randolph JJ, Grandey AA (2002) Relationship between coping, cognitive dysfunction and depression in multiple sclerosis. Clin Neuropsychol 16:341–355

    PubMed  Google Scholar 

  4. Benedetti MG, Piperno R, Simoncini L, Bonato P, Tonini A, Giannini S (1999) Gait abnormalities in minimally impaired multiple sclerosis patients. Mult Scler 5:363–368

    PubMed  CAS  Google Scholar 

  5. Bullinger M, Alonso J, Apolone G, Leplege A, Sullivan M, Wood-Dauphinee S, Gandek B, Wagner A, Aaronson N, Bech P, Fukuhara S, Kaasa S, Ware JE Jr (1998) Translating health status questionnaires and evaluating their quality: the IQOLA Project approach. International Quality of Life Assessment. J Clin Epidemiol 51:913–923

    Article  PubMed  CAS  Google Scholar 

  6. Bussone G, Usai S, Grazzi L, Rigamonti A, Solari A, D’Amico D (2004) Disability and quality of life in different primary headaches: results from Italian studies. Neurol Sci 25(Suppl 3):S105–S107

    Article  PubMed  Google Scholar 

  7. Cavalli-Sforza LL, Piazza A, Menozzi P, Mountain J (1988) Reconstruction of human evolution: bringing together genetic, archaeological and linguistic data. Proc Natl Acad Sci USA 85:6002–6006

    Article  PubMed  CAS  Google Scholar 

  8. Gandek B, Ware JE Jr (1998) Methods for validating and norming translations of health status questionnaires: the IQOLA Project approach. International Quality of Life Assessment. J Clin Epidemiol 51:953–959

    Article  PubMed  CAS  Google Scholar 

  9. Hemmet L, Holmes J, Barnes M, Russell N (2004) What drives quality of life in multiple sclerosis? Q J Med 97:671–676

    Google Scholar 

  10. Janssens ACJW, van Doorn PA, de Boer JB, van der Meche FGA (2003) Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurol Scand 108:389–395

    Article  PubMed  CAS  Google Scholar 

  11. Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452

    PubMed  CAS  Google Scholar 

  12. Landro NI, Celius EG, Sletvold H (2004) Depressive symptoms account for deficient information processing speed but not for impaired working memory in early phase multiple sclerosis (MS). J Neurol Sci 217:211–216

    Article  PubMed  Google Scholar 

  13. Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology 46:907–911

    PubMed  CAS  Google Scholar 

  14. Moons P (2004) Why call it health-related quality of life when you mean perceived health status? Eur J Cardiovasc Nurs 3:275–277

    Article  PubMed  Google Scholar 

  15. Nortvedt MW, Riise T, Myhr KM, Nyland HI (1999) Quality of life in multiple sclerosis: measuring the disease effects more broadly. Neurology 53:1098–1093

    PubMed  CAS  Google Scholar 

  16. Nortvedt M, Riise T, Myhr K-M, Nyland HI (2000) Quality of life as a predictor for change in disability in MS. Neurology 55:51–54

    PubMed  CAS  Google Scholar 

  17. Nortvedt MW, Riise T (2003) The use of quality of life measures in multiple sclerosis research. Mult Scler 9:63–72

    Article  PubMed  CAS  Google Scholar 

  18. Pittock SJ, Mayr WT, McClelland RL, Jorgensen NW, Weigand SD, Noseworthy JH, Rodriguez M (2004) Quality of life is favourable for most patients with multiple sclerosis. Arch Neurol 61:679–686

    Article  PubMed  Google Scholar 

  19. Picavet HS, Hoeymans N (2004) Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study. Ann Rheum Dis 63:723–729

    Article  PubMed  CAS  Google Scholar 

  20. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231

    Article  PubMed  CAS  Google Scholar 

  21. Poser CM (1995) Onset symptoms of multiple sclerosis. J Neurol Neurosurg Psychiatry 58:253–254

    PubMed  CAS  Google Scholar 

  22. Pugliatti M, Solinas G, Sotgiu S, Castiglia P, Rosati G (2001) Multiple sclerosis epidemiology in Sardinia: evidence for a true increasing risk. Acta Neurol Scand 103:20–26

    Article  PubMed  CAS  Google Scholar 

  23. Pugliatti M, Riise T, Sotgiu MA, Sotgiu S, Satta WM, Mannu L, Sanna G, Roati G (2005) Increasing incidence of multiple sclerosis in the province of Sassari, northern Sardinia. Neuroepidemiology 25:129–134

    Article  PubMed  Google Scholar 

  24. Raven JC, Court JH, Raven J (1998) Manual for Raven’s Coloured Progressive Matrices and Vocabulary Scales. Oxford: Oxford Psychologists Press

  25. Rothwell PM, McDowell Z, Wong CK, Dorman PJ (1997) Doctors and patients don’t agree: cross sectional study of patients’ and doctors’ perceptions and assessments of disability in multiple sclerosis. BMJ 314:1580–1583

    PubMed  CAS  Google Scholar 

  26. Rudick R, Antel J, Confavreux C, Cutter G, Ellison G, Fischer J, Lublin F, Miller A, Petkau J, Rao S, Reingold S, Syndulko K, Thompson A, Wallenberg J, Weinshenker B, Willoughby E (1996) Clinical outcomes assessment in multiple sclerosis. Ann Neurol 40:469–479

    Article  PubMed  CAS  Google Scholar 

  27. Ruggieri RM, Palermo R, Vitello G, Gennuso M, Settipani N, Piccoli F (2003) Cognitive impairment in patients suffering from relapsing-remitting multiple sclerosis with EDSS ≤ 3. 5. Acta Neurol Scand 108:323–326

    Article  PubMed  CAS  Google Scholar 

  28. Thomas PW, Thomas S, Hillier C, Galvin K, Baker R (2006) Psychological interventions for multiple sclerosis. Cochrane Database Syst Rev 25:CD004431

    Google Scholar 

  29. Thompson AJ, Hobart JC (1998) Multiple sclerosis: assessment of disability and disability scales. J Neurol 245:189–196

    Article  PubMed  CAS  Google Scholar 

  30. Wagner AK, Gandek B, Aaronson NK, Acquadro C, Alonso J, Apolone G, Bullinger M, Bjorner J, Fukuhara S, Kaasa S, Leplege A, Sullivan M, Wood- Dauphinee S, Ware JE Jr (1998) Crosscultural comparisons of the content of SF-36 translations across 10 countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51:925–932

    Article  PubMed  CAS  Google Scholar 

  31. Ware JE, Sherbourne CD (1992) The MOS 36-Item Short-Form Health Survey (SF-36) I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  32. Ware JE (1993) SF-36 Health Survey. Manual and interpretation guide. Boston: Health Institute, New England Medical Center

  33. Ware JE Jr, Keller SD, Gandek B, Brazier JE, Sullivan M (1995) Evaluating translations of health status questionnaires. Methods from the IQOLA project. International Quality of Life Assessment. Int J Technol Assess Health Care 11:525–551

    Article  PubMed  Google Scholar 

  34. Ware JE Jr, Kosinski M, Gandek B, Aaronson NK, Apolone G, Bech P, Brazier J, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M (1998) The factor structure of the SF-36 Health Survey in 10 countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51:1159–1165

    Article  PubMed  Google Scholar 

  35. Ware JE Jr, Gandek B (1998) Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol 51:903–912

    Article  PubMed  Google Scholar 

  36. Weinshenker BG (1994) Natural history of multiple sclerosis. Ann Neurol 36:S6–S11

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Istituto di Clinica Neurologica, University of Sassari, Viale San Pietro 10, 07100, Sassari, Italy

    M. Pugliatti, M. A. Sotgiu, S. Sotgiu & G. Rosati

  2. Dept. of Public Health and Primary Health Care, Section for Occupational Medicine, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway

    M. Pugliatti & T. Riise

  3. Faculty of Health and Social Sciences, Bergen University College, Research Department, Haugeveien 28, 5009, Bergen, Norway

    M. W. Nortvedt

  4. Azienda Ospedaliera USL, n. 1, Via Monte Grappa, 07100, Sassari, Italy

    G. Carpentras

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  1. M. Pugliatti
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  2. T. Riise
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  3. M. W. Nortvedt
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  4. G. Carpentras
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  5. M. A. Sotgiu
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  6. S. Sotgiu
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  7. G. Rosati
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Correspondence to M. Pugliatti.

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Pugliatti, M., Riise, T., Nortvedt, M.W. et al. Self-perceived physical functioning and health status among fully ambulatory multiple sclerosis patients. J Neurol 255, 157–162 (2008). https://doi.org/10.1007/s00415-008-0543-1

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  • DOI: https://doi.org/10.1007/s00415-008-0543-1

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