A Proposed Battery Used to Monitor Treatment Outcomes in Individuals with Multiple Sclerosis: A Case Study
Riggs, Amanda Lynn
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BACKGROUND: Multiple Sclerosis (MS) is a chronic disease of the central nervous system. As of now, there is no cure for MS, but different forms of treatment have been studied to ameliorate both physical and psychosocial symptoms. Numerous measures have been used within the MS population to monitor symptoms before, during, and after treatment. The aim of this present study was to ensure the usefulness of a battery of outcome measures that will assess MS-related symptoms before and after standard treatment. Another aim of the study was to assess treatment outcomes and determine the current success of each individualized treatment plan. SUBJECTS: All participants had a confirmed diagnosis of MS, were able to read and write in English, were 18 years of age and older, and able to walk, even briefly, with or without an assistive device. Participants were recruited through The University of Texas Southwestern Medical Center, Multiple Sclerosis Clinic. METHOD: Ten qualified MS patients were given a Six-minute walk test, two cognitive tests, and nine psychosocial measures as a baseline assessment. After six to eight weeks of Standard care, all participants were asked to return in order to complete all the measures again. It was hypothesized that the proposed battery of measures would prove to be useful in monitoring treatment outcomes in patients with MS. It was also hypothesized that individualized treatment would prove to be beneficial to each participant over the course of the study. RESULTS: This study did not provide any evidence that the individualized treatment was beneficial. Moreover, it did not provide any evidence that this particular battery was sensitive enough to truly monitor treatment outcomes. There was only one significant difference found between initial and follow-up assessment. The sum of ranks for the BORG was 0.00 (Z = -2.00, p = .046, r = -0.89) when comparing breathlessness scores. This indicates that individuals that returned for follow-up assessment experienced less breathlessness at follow-up assessment before and after the Six-minute Walk Test than before and after the Six-minute Walk test upon initial assessment. DISCUSSION: The period between assessments may not have been long enough to identify any changes in treatment or treatment outcomes. Due to the unpredictable nature of MS, it may be important for providers to assess individuals using a comprehensive, biopsychosocial battery on a case-by-case basis rather than a generalized pre-established time frame.