Validating a Community-Based Measure of Leg Use for Multiple Sclerosis
Impaired mobility is a cardinal disability for multiple sclerosis (MS). Of particular significance is how well patients with MS actually engage in walking and other uses of the lower extremities in the life situation. Although existing community-based assessments of lower extremity use reflect walking capacity or spontaneous walking for persons with MS, many other common lower extremity activities are excluded (e.g., exiting a car or shower, standing from a toilet). An alternate structured interview developed by our laboratory may more comprehensively assess lower extremity use as well as complement the other community-based assessments, and thus may improve assessing the extent of lower extremity disability for MS. The Lower Extremity Motor Activity Log (LE-MAL) consists of 3 subscales. The Functional Performance subscale asks respondents to rate the quality of their lower extremity use on 14 different activities on a scale of 0-10. The other 2 subscales evaluate confidence and orthotics/assistance in the same manner. The final score is the average from the 3 subscales.
(1) Assess the convergent validity of the LE-MAL with the MS Walking Scale-12 (MSWS-12) among persons with disabled walking following MS. (2) Assess the test-retest reliability of the LE-MAL among the same individuals.
16 adults ages 36-71 with recently stable relapsing-remitting or progressive MS and self-reported walking disability (PDSS range =1-6, mean = 4.3) were administered the LE-MAL and the MWSW-12 by telephone. Within 2-4 weeks the LE-MAL was readministered.
The LE-MAL was highly correlated with the MSWS-12 (r = 0.83, p <0.001) and demonstrated excellent test-retest reliability (r = 0.99, p<0.001).
The LE-MAL has convergent validity with the MSWS-12 over a wide range of walking abilities and is reliable. It is sensitive to real-world lower extremity use for a wider range of activities important to persons with MS than other scales. The LE-MAL may add value to clinical and research programs concerning lower extremity disability for persons with MS.