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Disease Steps assesses functional disability in MS patients.
2
15-35 minutes
Initially reviewed by Susan E. Bennett, PT, DPT, EdD, NCS, MSCS and the MS EDGE task force of the neurology section of the APTA in 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: |
|
|
HR |
Highly Recommend |
|
R |
Recommend |
|
LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations based on level of care in which the assessment is taken:
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Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
|
MS EDGE |
R |
R |
R |
R |
R |
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 |
R |
R |
R |
R |
Recommendations for entry-level physical therapy education and use in research:
|
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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 |
No |
Yes |
No |
No |
Disease Steps is heavily weighted towards ambulation. Unclassifiable patients include individuals with severe visual impairment, overwhelming fatigue, significant bowel or bladder involvement, or severe cognitive impairment in patients with otherwise minor physical disability.
Disease Steps may be more sensitive for patients who use unilateral support.
May not capture acute attacks and does not incorporate measures of disease activity such as attack frequency.
May not be for a skilled nursing facility as a majority of patients there would be a 6 on the scale.
Scale is specific to MS and strongly correlates with the EDSS gold standard.
Recommended for EDSS 0.0-9.5.
Recommended for entry-level curricula.
Not recommended for research purposes; possible limited objectivity with the scale. More objective scales include Timed 25’ Walk, 2- or 6-minute Walk, or 5 Times Sit to Stand.
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Multiple Sclerosis:
(Hohol et al., 1999)
Multiple Sclerosis:
(Hohol et al., 1999)
Multiple Sclerosis:
(Hohol et al., 1995)
(Hohol et al., 1999)
Hohol, M. J., Orav, E. J., et al. (1995). "Disease steps in multiple sclerosis: a simple approach to evaluate disease progression." Neurology 45(2): 251-255. Find it on PubMed
Hohol, M. J., Orav, E. J., et al. (1999). "Disease steps in multiple sclerosis: a longitudinal study comparing disease steps and EDSS to evaluate disease progression." Mult Scler 5(5): 349-354. Find it on PubMed
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.