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Comparison between impairment and disability scales in immune‐mediated polyneuropathies
Author(s) -
Merkies Ingemar S.J.,
Schmitz Paul I.M.,
van der Meché Frans G.A.,
van Doorn Pieter A.
Publication year - 2003
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.10410
Subject(s) - wilcoxon signed rank test , chronic inflammatory demyelinating polyneuropathy , medicine , correlation , rank correlation , physical medicine and rehabilitation , physical therapy , polyneuropathy , audiology , psychology , statistics , mann–whitney u test , mathematics , immunology , antibody , geometry
The ability of a scale to detect clinical relevant changes over time, i.e., its “responsiveness,” may help clinicians to choose among valid and reliable measures. Therefore, we investigated the responsiveness' rank ordering (best to worse) of six selected valid and reliable scales, namely the Medical Research Council (MRC)‐sumscore, sensory‐sumscore, grip‐strength (Vigorimeter), nine‐hole peg, ten‐meters walking, and a disability‐sumscore, in immune‐mediated polyneuropathies. Patients with newly diagnosed Guillain–Barré syndrome ( n = 7) or chronic inflammatory demyelinating polyneuropathy ( n = 13) were examined over 52 weeks. Responsiveness of each scale was measured using different methods (effect‐size, standardized response mean score, Wilcoxon matched‐pairs signed‐rank, and a newly devised Schmitz's distribution‐free responsiveness score), and the obtained scores in each method were plotted against the follow‐up period, thus allowing area‐under‐the‐curve calculations (higher area‐under‐the‐curve indicating better responsiveness). Also, longitudinal correlations were performed between the scales' values and patients' own clinical judgments (deteriorated, unchanged, improved) (higher correlation = better responsiveness). A consistent rank ordering was observed in each technique with the disability‐sumscore, MRC‐sumscore, and Vigorimeter being among the best responsive scales. Hence, the primary use of these measures is suggested in studies of immune‐mediated polyneuropathies. Muscle Nerve 28: 93–100, 2003