The 12-item Multiple Sclerosis Walking Scale (MSWS-12) is a self-report measure of the impact of MS on the individual’s walking ability.
12
Less than or equal to 10 minutes
Adult
18 - 64
yearsElderly Adult
65 +
yearsInitially reviewed by Diane D. Allen, PT, PhD and the MS EDGE taskforce of the Neurology Section of the APTA in July 2011.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations based on EDSS Classification:
| EDSS 0.0 – 3.5 | EDSS 4.0 – 5.5 | EDSS 6.0 – 7.5 | EDSS 8.0 – 9.5 | |
| MS EDGE | HR | HR | HR | NR |
Recommendations for entry-level physical therapy education and use in research:
| Students should learn to administer this tool? (Y/N) | Students should be exposed to tool? (Y/N) | Appropriate for use in intervention research studies? (Y/N) | Is additional research warranted for this tool (Y/N) | |
| MS EDGE | Yes | Yes | Yes | No |
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Healthy Adults:
(Goldman, MD et al, 2008; n = 20 healthy controls; average MSWS-12 score = 2.2 (5.6))
Multiple Sclerosis:
(Goldman, MD et al, 2008; n = 40 MS patients; average MSWS-12 = 28.2 (25); EDSS = 0 – 6.5)
Multiple Sclerosis:
(Hobart JC et al, 2003; n = 400 people with MS in community)
(Motl RW et al, 2011; n = 260 people with MS)
Multiple Sclerosis:
(Hobart JC et al, 2003; n = 54 to n = 602 for MS patients)
(McGuigan C et al, 2004; n = 149 in community population; n = 53 in outpatient population with MS)
Multiple Sclerosis:
Concurrent validity:
(Cavanaugh JT et al, 2011; n = 21 people with MS; EDSS = 3.5 – 7.5; MSWS-12 scores correlated with Daily Step Count, T25FW, six-minute walk test, BBS and ABC; Spearman’s rho correlation used)
Excellent for Daily Step Count (rho = -0.83)
Excellent for T25FW (rho = 0.78)
Excellent for six-minute walk test (rho = -0.80)
Excellent for BBS (rho = -0.78)
(Goldman, MD et al, 2008; n = 40 people with MS; EDSS = 0 – 6.5; Spearmans’ rho used for correlation)
(Hobart JC et al, 2003; n = 54 for EDSS; n = 78 patients for physical functioning scale of the SF-36; n = 602 community people for the physical portion of the MSIS-29; n = 54 patients with the T25FW; Pearson’s r for correlation used)
(McGuigan C et al, 2004; n = 54 for EDSS; n = 78 patients for physical functioning scale of the SF-36; n = 602 community people for the physical portion of the MSIS-29; n = 54 patients with the T25FW; Spearman’s rho for correlation used)
(Motl RW et al, 2008; n = 133 people with MS; Spearman’s rho for correlation of the MSWS-12 with accelerometer counts over a 7-day period was 0.68)
(Motl RW et al, 2010; n = 24 people with MS; Pearson’s r showed a correlation of the MSWS-12 with oxygen cost (ml/kg/meter) but not for oxygen consumption (ml/kg/minute) for the six-minute walk test)
(Nilsagard Y et al, 2007; n = 81 people with MS; EDSS 3.5 – 6.0; Kendall tau coefficient used for correlation)
(Sosnoff JJ et al, 2011; n = 13 people with MS; Spearman rho correlation between MSWS-12 and gait velocity as measured by an instrumented gait mat)
Predictive validity:
(Nilsagard Y et al, 2009; n = 76 people with MS; EDSS = 3.5 – 6.0; people who recorded at least one fall in the 3 month data collection period had an average of 75 on the MSWS-12 compared to 58 in non-fallers; OR = 1.03, Cl 95% 1.01 – 1.05)
Multiple Sclerosis:
Floor Effects:
(Hobart JC et al, 2003; n = 602 people in community with MS; n = 54 with MS undergoing steroidal treatment)
Ceiling Effects:
(Hobart JC et al, 2003; n = 602 people in community with MS; n = 54 with MS undergoing steroidal treatment)
Multiple Sclerosis:
(Hobart JC et al, 2003; n = 53 patients with MS undergoing steroid treatment compared to EDSS and T25FW)
(McGuigan C et al, 2004; the MSWS-12 changed more (mean = 19.3) in people who had a change of greater than or equal to 1 in EDSS scores than people who had no change in EDSS score in a 6 – 24 month period)
(Nilsagard et al, 2009; n = 76 with MS; EDSS = 3.5 to 6.0; A cut-off of greater than or equal to 75 had a sensitivity of 52 and a specificity of 82 in predicting fallers vs. non-fallers.
(Riazi A et al, 2004; n = 43 patients receiving rehabilitation for MS; n = 46 patients receiving steroid treatment)
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Cavanaugh, J. T., Gappmaier, V. O., et al. (2011). "Ambulatory activity in individuals with multiple sclerosis." J Neurol Phys Ther 35(21475081): 26-33. Filiatrault, J., Gauvin, L., et al. (2007). "Evidence of the psychometric qualities of a simplified version of the Activities-specific Balance Confidence scale for community-dwelling seniors." Arch Phys Med Rehabil 88(5): 664-672. Find it on PubMed Goldman, M. D., Marrie, R. A., et al. (2008). "Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls." Mult Scler 14(17942508): 383-390. Hobart, J. C., Riazi, A., et al. (2003). "Measuring the impact of MS on walking ability: the 12-Item MS Walking Scale (MSWS-12)." Neurology 60(12525714): 31-36. Hutchinson, B., Forwell, S. J., et al. (2009). "Toward a consensus on rehabilitation outcomes in MS: gait and fatigue." International Journal of MS Care 11(2): 67-78. McGuigan, C. and Hutchinson, M. (2004). "Confirming the validity and responsiveness of the Multiple Sclerosis Walking Scale-12 (MSWS-12)." Neurology 62(15184625): 2103-2105. Motl, R. W., Dlugonski, D., et al. (2010). "Multiple Sclerosis Walking Scale-12 and oxygen cost of walking." Gait Posture 31(20226676): 506-510. Motl, R. W., McAuley, E., et al. (2011). "Longitudinal measurement invariance of the Multiple Sclerosis Walking Scale-12." J Neurol Sci 305(21474149): 75-79. Motl, R. W. and Snook, E. M. (2008). "Confirmation and extension of the validity of the Multiple Sclerosis Walking Scale-12 (MSWS-12)." J Neurol Sci 268(18061618): 69-73. Nilsagård, Y., Gunnarsson, L. G., et al. (2007). "Self-perceived limitations of gait in persons with multiple sclerosis." Advances in Physiotherapy 9(3): 136-143. Nilsagard, Y., Lundholm, C., et al. (2009). "Predicting accidental falls in people with multiple sclerosis -- a longitudinal study." Clin Rehabil 23(3): 259-269. Find it on PubMed Riazi, A., Thompson, A. J., et al. (2004). "Self-efficacy predicts self-reported health status in multiple sclerosis." Mult Scler 10(14760954): 61-66. Sosnoff, J. J., Weikert, M., et al. (2011). "Quantifying gait impairment in multiple sclerosis using GAITRite technology." Gait Posture 34(21531562): 145-147. |
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.