Toward a Consensus on Rehabilitation Outcomes in MS: Gait and Fatigue

Abstract

A multidisciplinary consensus conference was held on November 28–29, 2007, by the Consortium of Multiple Sclerosis Centers (CMSC) to determine the most appropriate outcome measures for gait and fatigue in people with multiple sclerosis (MS). The goals of this conference were to 1) improve understanding of gait and fatigue outcome measures being used by rehabilitation professionals treating people with MS; 2) establish consensus on outcome measures; and 3) establish consensus on required follow-up for transfer of this knowledge to rehabilitation professionals. The consensus conference and this document are the initial steps toward achieving the stated goals. Although many measures of fatigue exist, it was recommended that a global outcome measure for fatigue be developed that would 1) include a screen for the functional ramifications of fatigue for activities and participation; 2) be quick and easy to administer; 3) demonstrate psychometric integrity for MS; and 4) examine fatigue over a continuum of the MS disease course. In addition, it was recommended that an assessment battery for fatigue be developed. With respect to gait outcome measures, it was agreed that the following tools should be included in a preliminary chart for use in a clinical setting: the Timed 25-Foot Walk, Timed Up and Go test, Dynamic Gait Index, 6-Minute Walk, and self-reported 12-item Multiple Sclerosis Walking Scale. The global outcome fatigue measure and assessment battery are currently being developed, and work on a detailed gait outcome measures chart and additional research on commonly used gait outcome measures are in progress.