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Article Abstract
Background: In multiple sclerosis (MS), the Expanded Disability Status Scale (EDSS) reflects disease severity. Although parts of the EDSS are dependent on actual walking distance, self-reported statements are often applied.
Objectives: The purpose of the present study was, therefore, to compare self-reported walking distance to actual walking distance to outline how this influences EDSS scoring.
Methods: MS patients with EDSS 4.0-7.5 ( = 273) were included from the Danish MS hospitals rehabilitation study ( = 427). All patients subjectively classified their maximal walking distance according to one of seven categories (>500; 300-499; 200-299; 100-199; 20-99; 5-19; 0-4 m). Subsequently, actual maximal walking distance was assessed and EDSS was determined from both self-reported walking distance (EDSS) and actual walking distance (EDSS).
Results: In 145 patients (53%), self-reported walking distance was misclassified when compared to the actual walking distance. Misclassification was more frequent in patients using walking aids (64% vs. 44%, < 0.05) and in patients with primary progressive MS (69%, < 0.05). Misclassification of walking distance corresponded to incorrect EDSS scores (EDSS vs EDSS) of ⩾0.5 point in 24%.
Conclusion: In MS patients with EDSS 4.0-7.5, 53% misclassified their walking distance yielding incorrect EDSS scores in 24%. Therefore, correct EDSS determination must be based on measurement of actual walking distance.
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