Physical Functioning Among Older Adults with MS: Evidence Based on an Objective Outcome
Objectives: We compared physical functioning in older adults with MS and an age-matched control group using the Short Physical Performance Battery (SPPB). The SPPB is an extensively-validated objective measure for characterizing lower extremity function in older adults and has recently been validated in older adults with MS.
Methods: The convenience sample included 20 older adults with MS and 20 controls matched on age, sex, height, and weight. All participants completed the SPPB, and those with MS further underwent a neurological examination for generation of an EDSS score. The SPPB includes assessments of balance, gait speed, and lower extremity strength, and those assessments are aggregated into a summary SPPB score.
Results: Among the older adults with MS, the summary SPPB scores ranged between 2 and 12, and the mean SPPB score was 9.4 (SD=2.1). This was significantly lower than the mean scores of 11.6 (SD=0.7) for controls (p<.001), with an effect size that was large in magnitude (d=−1.4). There were statistically significant differences between groups in the assessments of balance (p<.005), gait speed (p<.05), and lower extremity strength (p<.005). The effect sizes were large in magnitude for balance (d=−1.5), gait speed (d=−1.1), and lower extremity strength (d=−1.2).
Conclusions: These data suggest that this sample of older adults with MS exhibited substantially worse physical function than that of a sample of older adults, and the decrements occur across all domains objectively assessed by the SPPB.