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The use of multiple sclerosis condition-specific measures to inform health policy decision-making: mapping from the MSWS-12 to the EQ-5D.
Mult Scler. 2012 Jun;18(6):853-61
Authors: Hawton A, Green C, Telford CJ, Wright DE, Zajicek JP
Abstract
BACKGROUND: Walking impairment has a major influence on the quality of life of people with multiple sclerosis (MS). The Multiple Sclerosis Walking Scale (MSWS-12) assesses the impact of MS on walking ability from the patient's perspective, but in its current form, is not amenable for use in many policy decision-making settings.
OBJECTIVES: Statistical 'mapping' methods were used to convert MSWS-12 scores to EQ-5D health state values.
METHODS: The relationship between the measures was estimated using cohort data from people with MS in South West England. Regression analyses were conducted, estimation errors assessed, and predictive performance of the best models tested using longitudinal data.
RESULTS: Model performance was in line with that of other mapping studies, with the best-performing models being an ordinary least squares (OLS) model using MSWS-12 item scores, and an OLS model using the total MSWS-12 score and its squared term.
CONCLUSIONS: A process has been described whereby data from a patient-reported outcome measure (MSWS-12) can be converted to (EQ-5D) health state values. These values may be used to consider the health-related quality of life of people with MS, to estimate quality adjusted life-years for use in effectiveness and cost-effectiveness analyses, and to inform health policy decisions.
PMID: 22108867 [PubMed - indexed for MEDLINE]

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Seated stepping exercise in a dual-task condition improves ambulatory function with a secondary task: a randomized controlled trial.
Aging Clin Exp Res. 2011 Oct-Dec;23(5-6):386-92
Authors: Yamada M, Aoyama T, Tanaka B, Nagai K, Ichihashi N
Abstract
BACKGROUND AND AIMS: A close relationship exists between dual-task (DT)-related gait changes and the risk of falling in the elderly. However, the impact of DT training on the incidence of falls in the elderly remains unclear. We aimed to evaluate the effects of a seated stepping exercise in DT conditions to improve walking ability in community-dwelling elderly.
METHODS: This was a randomized controlled trial (RCT) in community-dwelling elderly in Japan. Fifty-three participants were randomly assigned to a DT group (stepping exercise in DT conditions, n=26) and a singletask (ST) group (stepping exercise in ST conditions, n=27). All participants received 50 min group training sessions, once a week for 24 weeks. Outcome measures were based on differences in walking ability in singletask (ST), cognitive-task (CT), and manual-task (MT) conditions between DT and ST groups.
RESULTS: Participants in the DT group showed significantly greater improvement in outcome measures, including 10-m gait speed, walking cadence, and cost during cognitive and manual tasks. The number of enumerated figures during CT, as well as the numbers of steps taken and of enumerated figures during stepping with MT demonstrated significant Group × Time interactions (p<0.05).
CONCLUSIONS: This RCT suggests that the seated stepping exercise is more effective at improving ambulatory function in DT conditions than in ST conditions.
PMID: 21042047 [PubMed - indexed for MEDLINE]

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