Incidence of Stroke and Transient Ischemic Attack in Croatia: A Population Based Study.

The aim of this population based neuroepidemiological study was to establish the real incidence rates of acute cerebrovascular disease (CVD): stroke and transient ischemic attack (TIA) in the Republic of Croatia. Multicentric study included 89 501 persons of all ages in four regional centres in Croatia: Zagreb, Osijek + Slavonski Brod, Rijeka and Split. The following incidence rates of stroke, expressed at population of 100 000, have been established: Zagreb 290.52, Osijek + Slavonski Brod 302.14, Rijeka 219.65, Split 195.82. Incidence rate of stroke for the Republic of Croatia is 251.39. The following incidence rates of TIA, expressed at population of 100,000, have been established: Zagreb 87.15, Osijek + Slavonski Brod 156.53, Rijeka 90.11, Split 59.10. Incidence rate of TIA for the Republic of Croatia is 100.55. In the continental part of Croatia (Zagreb, Osijek + Slavonski Brod) incidence rate of stroke is higher by 45%, while incidence rate of TIA is higher by 82% than in the coastal part of Croatia, probably due to different lifestyle and environmental factors. The study has shown relatively high incidence rates of acute CVD (stroke and TIA) in the Republic of Croatia, which proves that CVD are a great public health problem.

Responsiveness of walking-based outcome measures after multiple sclerosis relapses following steroid pulses.

BACKGROUND: The aim of this study was to examine the impact of intravenous methylprednisolone therapy (IVMP) on the recovery of walking ability in patients experiencing multiple sclerosis (MS) relapses, to compare the responsiveness of walking-based measures, and to estimate the impact of different walking-based measures responsiveness on clinical trials. MATERIAL/METHODS: The study included 49 consecutive patients with relapsing-remitting MS who received Solu-Medrol 1000 mg/day over 3 days for relapse with difficulties in walking. The following walking-based measures were administered before and a month after IVMP: the Multiple Sclerosis Walking Scale-12 (MSWS-12), the Expanded Disability Status Scale (EDSS), the 2-minute timed walk (2-minTW), the 25-foot walk test (25FWT), the Six Spot Step Test (SSST). All patients had worn the step activity monitor accelerometer (SAM) 1 week prior to IVMP was applied and wore it again the fourth week upon the corticosteroid therapy was completed. The SAM analysis utilized the average daily step count and data regarding frequency and intensity of walking over a continuous time interval. We examined: (1) the impact of IVMP on the recovery of walking ability; (2) the responsiveness of each walking-based measure; (3) the relative responsiveness of competing walking-based measures; and (4) the impact of different walking-based measures responsiveness on clinical trials. RESULTS: All walking-based measures showed significant improvement of walking ability 1 month after the IVMP. The most responsive were MSWS-12 and EDSS. Different responsiveness implied a greater than 6-fold impact on sample size estimates. CONCLUSIONS: All applied walking-based measures showed significant improvement of walking ability 1 month after the IVMP. Responsiveness of various walking-based measures notably differ, thus affecting sample size calculations.

Psychometric validation of the Croatian version of the Quality of Life in Epilepsy Inventory (QOLIE-31).

The primary goals of this study were to adapt the Quality of Life in Epilepsy Inventory-31 items (QOLIE-31) questionnaire to the Croatian language and to assess the translated questionnaire's psychometric properties. Translation/retranslation of the English version of the QOLIE-31 was done, and all steps for cross-cultural adaptation process were performed properly by an expert committee. Later, QOLIE-31 questionnaires and previously validated Short Form-36 (SF-36) outcome instruments were given to 200 patients with epilepsy. 172 patients (86%) responded to the first set of questionnaires, and 114 of the first time respondents (66%) returned their second survey. The two measures of reliability as internal consistency and reproducibility were determined by Cronbach alpha statistics and intraclass correlation coefficient, respectively. Concurrent validity was measured by comparing with a SF-36 questionnaire, and measurement was made using the Pearson correlation coefficient (r). The study demonstrated satisfactory internal consistency with high Cronbach a values for all of the corresponding domains (seizure worry 0.84, medication effects 0.80, emotional well-being 0.73, energy/fatigue 0.76, cognitive functioning 0.71, social functioning 0.77, overall quality of life 0.65). The intraclass correlation coefficient for six domains of QOLIE-31 questionnaire demonstrated excellent test/retest reproducibility (ICC > or = 0.75), and good test/retest reproducibility (ICC 0.71) in one domain (cognitive functioning). Considering concurrent validity, three domains had excellent correlation (r = 0.75-1), while 11 had good correlation (r = 0.50 to 0.75), and 3 had moderate correlation (r = 0.25-0.50). This study demonstrated that, if measures are to be used across cultures, the items must not only be translated well linguistically but also must be culturally adapted to maintain the content validity of the instrument at a conceptual level across different cultures. Croatian version of QOLIE-31 will be a valuable contribution to outcome measurement in epilepsy patients, particularly in the context of treatment trials, but als in a wider research context.

[Epilepsy in the Split-Dalmatia county--prevalence and therapeutic approaches]. / Epilepsija u Splitsko-dalmatinskoj regiji--prevalencija i terapijski pristupi.

The aim of the study was to determine the prevalence of epilepsy in the Split-Dalmatia County. The study was carried out in a sample of 140,493 County inhabitants. There were 883 epilepsy patients in the study sample, showing a male predominance. The prevalence of epilepsy was 6.29/1,000 inhabitants, roughly corresponding to the results recorded in other populations. The highest prevalence was found in Vrlika, where patients with severe mental retardation are institutionalized. Other places showed a uniform distribution. The mean patient age was 41.02b +/- 3.4 years, with a mean of 1.33 drugs per patient. There was no statistically significant sex difference in the number of drugs used. The largest number of patients were on monotherapy, wherease only 0.45% of patients were taking no therapy at all. Study results are consistent to those reported in developed countries.

Parkinsonism and multiple sclerosis--is there association?

Association between multiple sclerosis (MS) and parkinsonism is rarely reported. We describe clinical, radiological and DAT scan findings in two patients presenting with parkinsonism. MRI revealed demyelinating lesions of the central nervous system consistent with MS in both patients. On the other hand, DAT scan findings were supportive of Parkinson's disease. There is still an open debate whether MS lesions can cause parkinsonism, or these are just coincidental findings of two different diseases in the same patient. Although there are cases of causal relationship between parkinsonism and MS, some literature reports and our observations suggest that Parkinson's disease and MS can coexist as two separate diseases in the same patient. It is possible that the symptoms of Parkinson's disease can be aggravated by MS plaques, explaining the favorable response to corticosteroids in some patients.

[Triptans--pivotal event in migraine treatment]. / Triptani--prekretnica u lijecenju migrene.

Introducing serotonin 5-HT1B/1D agonists in the migraine treatment in the early 1990s had for the first time set guidelines for targeting a hypothetic physiologic source of the sequence of events in migraine, and results thus achieved were considerably better than those accomplished with earlier nonselective pharmacological approach. Triptans have revolutionized migraine management and inspired many epidemiological and public health surveys, strengthened efforts in understanding pathophysiology of migraine and initiated synthesis of many similar drugs in the triptan group, the first being sumatriptan. Triptans have risen to a therapeutic challenge posed by migraine, successfully thwarting the cycle of pain. In treating migraine sufferers, physicians can choose among seven triptans with different attributes. Each patient merits individualized approach in the treatment of migraine with triptans. Choosing the right triptan for a given patient is a matter of first matching the appropriate formulation to the patient, then deciding which agent will best meet the patient's needs. This process requires thorough understanding of the patient, careful and accurate assessment of the efficacy of previous medications used in acute care, and analysis of the individual features of the triptans being considered.

[Brain damage assessment in patients with multiple sclerosis by means of MRI]. / Procjena ostecenja mozga magnetskom rezonancijom oboljelih od multiple skleroze.

Brain magnetic resonance imaging (MRI) findings in 32 patients recently clinically diagnosed with multiple sclerosis (MS) by McDonald's criteria are presented. Demyelinization plaques were examined according to their number, size and location in brain tissue. Classification was done by Frederiksen's quantification. The study included 18 (56.3%) female and 1-4 (43.7%) male patients aged 17-44, mean 32 +/- 2.4 years. The predominant plaque location was periventricular (100%), involving lateral brain chambers, followed by subcortical, pontine, corpus callosum, cerebellar and other locations (medulla oblongata, spinal marrow). According to plaque number, patients were divided into six groups, from 2-6 plaques (group 1), to 26 lesions (divided into four subgroups). Patients with at least one plaque 15 mm in diameter were allocated to a separate group. The largest was the group with 7-15 plaques (37%). According to plaque size, patients were divided into three groups: plaque of up to 6 mm in diameter, 6-15 mm in diameter, and at least one plaque 15 mm in diameter. Patients with plaque size 6-15 mm were found to predominate (64%). There was a surprisingly high incidence of severe brain damage, i. e. higher degrees by Frederiksen's quantification. The third and fourth quantification degrees were most common, with a significant number of plaques not exceeding 15 mm in diameter; however, there also were been patients with plaques of 15 mm in diameter, which is quite surprising at this early stage of the disease. This pilot study indicated that research should be extended to patients newly clinically diagnosed with MS, comparing their clinical symptoms and Frederiksen's quantification.

[Evidence based guidelines for the treatment of primary headaches]. / Smjernice za lijecenje primarnih glavobolja zasnovane na dokazima.

Some patients suffering from headache require neurologic examination. The objective of the guidelines for the treatment of headaches is to help physicians in their daily care for headache patients. In most patients, the diagnosis of migraine has not been made by a physician and they have not received appropriate care to treat migraine attacks. New therapeutic methods (for acute and preventive treatment) have been introduced in the past fifteen years. Triptans should be offered to patients that fail to respond to usual analgesics, those with moderate to severe migraine in particular. Depending on comorbidity, preventive therapy should be recommended to individuals with frequent or prolonged migraine attacks. In patients with tension headaches, organic causes underlying the headache should be ruled out, while the treatment includes pharmacological and non-pharmacological measures. Although rare, patients with cluster headaches suffer severe pain; oxygen inhalation or triptans are recommended for acute attack, and preventive therapy may be indicated in some cases. The guidelines provide classification, diagnostic criteria and therapeutic principles for primary headaches. All recommendations listed in the guidelines are based on meta-analyses and recommendations from the world literature, with special reference to therapeutic options available in Croatia.

[Evaluation of work results in the Department of Neurology Split, University Hospital, in one-year period compared to the national standards]. / Evaluacija rada Klinike za neurologiju Klinicke bolnice Split u jednogodisnjem razdoblju u odnosu na nacionalne standarde.

Department of Neurology, Split University Hospital has 77 contracted hospital beds. 70 health professionals were employed in the Department; 17 medical doctors and 53 nurses. Aim was to evaluate work results in the one-year period with emphasis on the number of employed health professionals compared to the standards defined by the Ministry of Health. Age median of medical doctors specialists was 42.0 years. Length of stay median was 8.0 days. Average bed occupation rate in the Department of Neurology in 2005 was 88%. Shortage of nurses in the Department was determined as the result of analyses of required number of nurses for the Department compared with national standards. Despite the shortage of medical professionals in the Department, work results were better than national, displayed with average bed occupation rate and average length of stay. Neurological diseases have growing share in the human pathology, and adequate organization and implementation of out-of-clinic and clinic health services is a priority in the national health strategy.

Concussion knowledge among family physicians in Croatia.

AIM: The objective of this study was to administer and analyze results of a survey targeting knowledge about concussion symptoms, diagnosis, treatment and expected recovery among family medicine specialists in the Split-Dalmatia County of Croatia. METHODS: An electronic survey questionnaire was developed utilizing concepts from previously published studies on concussion knowledge, attitudes and beliefs completed by physicians. The survey was intended to briefly and broadly assess concussion knowledge of Croatian healthcare providers. The first section of the survey included five questions clarifying professional practice, years of experience and experience with concussions; the second section included 15 questions about typical concussion symptoms; the third section included 12 questions focused upon three primary components of concussion knowledge: concussion diagnosis, treatment and recovery. RESULTS: Out of 242 surveys mailed, 81 questionnaires (33%) were completed while 161 respondents (67%) did not answer. Out of the 81 completed surveys, 76 (94%) were returned by family physicians specialist and five (6%) by resident physicians in training. 39 (48%) had treated less than ten patients with concussion during last year: 40 (49%) treated 11-20 patients with concussion; and two (3%) treated greater than 20 patients with concussion during last year. While most responses did accurately reflect knowledge of common symptoms (90-100% correct), there was significant lack of knowledge in three areas: only 19% of participants stated that diagnosis of concussion does not require loss of consciousness; three quarters of respondents believed that a diagnosis of concussion requires direct contact to the head and 83% of the respondents believed that persistent subjective complaints are always the result of a more severe initial injury. DISCUSSION: This is the first investigation conducted in Croatia to examine knowledge of concussion diagnosis, as well as the management practices held by medical professionals. Overall, the findings suggest that the knowledge and management practices among family doctors in the region are not consistent with current worldwide views and recommendations. There was not an accurate knowledge of concussion diagnosis, treatment, recovery and prognosis among family physicians. Continued education of medical staff to better identify concussion and increased reliance on objective methods for managing concussion will improve patient management and outcome.

Progression of optic neuritis to multiple sclerosis in the County of Split-Dalmatia, Croatia.

The aim of this study was to determine the incidence of monosymptomatic optic neuritis (MON) and progression of MON to multiple sclerosis (MS) from the Mediterranean region of southern Europe in the County of Split-Dalmatia, Croatia during the 11 years period from 1991 to 2001. This study was made retrospectively on the 87 cases (59 female, aged 25.9 +/- 11.3 and 28 male aged 29.9 +/- 9.2) of MON, which were treated at the Department of Ophthalmology and Department of Neurology, Split, University Hospital, from January 1991 to December 2001. In each case the diagnosis was confirmed by a chart review and cases were ascribed to the data of admittance at hospital. The annual incidence of MON was 1.9 per 100,000 (95% CI, 0.4-3.5). The incidence among males was 1.2 (95% CI, 0-2.9) cases / 100,000 per year and 2.5 (95% CI, 0.1-4.9) among females. A significant seasonal variations in the incidence of MON was not found (chi2 = 6.81, p = 0.08). MS developed in 20 of 87 patients (22.9%) and median time was 25 (SE 8) months, (95% CI, 9-41) after the MON onset. After two years 12.6% of patients with MON developed MS, 20.6% after 5 years and 22.9% after 10 years. MS was slightly but not significantly more frequent in women than in men (chi2 = 0.72, p = 0.3). In conclusion, the progression of MON to MS in the County of Split-Dalmatia, Croatia was at a relatively moderate frequency.

[Study of quality of life in patients with multiple sclerosis]. / Kvaliteta zivota u oboljelih s multiplom sklerozom.

INTRODUCTION: Multiple sclerosis (MS) is a neurological impairment mostly affecting younger adults substantially decreasing their working and living abilities. Different rating scales to determine disabilities are being used: EDSS, NRS, and CAMBS. The objective of this study was to assess the quality of life in MS patients, with reference to the disease itself and its treatment, comparing patients with MS and a matching healthy control group. METHODS AND SUBJECTS: Subjects were divided into two groups, a group of patients with MS and a control group of healthy subjects. There were 37 MS patients, 25 women and 12 men. Control group consisted of 51 subjects, 39 women and 12 men. There was no statistically significant sex difference. The mean age of the MS patients was 45.9 +/- 12.4 years, and of control group 42.4 +/- 10.3 years; yielding no statistically significant difference. The severity of impairment in MS patients according to EDSS scale was 3 to 3.5. The quality of life determined by the prediction and criterion variables was studied in both MS patients groups and control group. All variables were graded on a 1 to 5 scale. On statistical data processing chi2 test and t-test were used. RESULTS AND DISCUSSION: Predictors referring to family history, sexual life, social life, satisfaction with education, job, social environment, religious life, housing status, financial status and present family life did not differ between the MS and control group. MS patients were less satisfied with their place in society, their state of health and ways of spending their free time. The decrease of satisfaction correlated with the areas generally known to be directly or indirectly affected by MS. As to the criterion variable of 'satisfaction with former way of life' no significant differences were found, since the disease did not affect previous life achievements. MS patients were less satisfied with their status in society, their state of health and ways of spending their free time. Changes occurred as a consequence of substantial life changes caused by the disease, results of treatments and circumstances in which the patients lives. Results obtained indicated that patients were aware of their disease, lower quality of life that limited their daily activities and future plans. Answers referring to the state of health, social status, and sexual activities did not show any statistically significant difference between the groups of MS patients and healthy controls, although it could have been expected according to the experience and customary expectations in such cases. CONCLUSION: MS patients are mainly satisfied with what they have achieved previously as young people; they become dissatisfied in relation to the possible economic and social prospects, and they are aware of their disabilities and weaknesses, inability for professional development, working and workplace relationships, more difficult money acquisition, etc.

Autonomic dysfunction in clinically isolated syndrome suggestive of multiple sclerosis.

OBJECTIVES: The aim of this study was to determine the extent of autonomic dysfunction in patients with clinically isolated syndrome (CIS) by using a standardized battery of autonomic tests in the form of the Composite Autonomic Scoring Scale (CASS). METHODS: This was a prospective, cross sectional study which included 24 consecutive patients who were diagnosed with CIS and 17 healthy controls. In all participants, heart rate and blood pressure responses to the Valsalva maneuver, heart rate response to deep breathing and blood pressure response to passive tilt were performed. In 16 patients, Quantitative Sudomotor Axon Reflex Test (QSART) and catecholamine measurement was performed. RESULTS: The proportion of CIS patients with pathological adrenergic index was statistically significantly higher compared to healthy controls (12 vs 2, p=0.018), while there was no difference in cardiovagal index between groups. Five patients had a sudomotor index of 1 (in 4 there was hypohydrosis <50% and in 1 persistent foot hyperhidrosis). When combining adrenergic, cardiovagal and sudomotor index into CASS, 8 patients (50%) had evidence of autonomic dysfunction, 7 mild and one moderate. CONCLUSION: Sympathetic nervous system is frequently affected in CIS patients. SIGNIFICANCE: CASS is able to detect autonomic nervous system dysfunction in CIS patients.

[Epileptic patient compliance with prescribed medical treatment]. / Suradljitvost bolesnika s epilepsijom.

Medically treated patients' non-compliance with the prescribed scheme is an exceptionally important issue, faced relatively often in medical treatment of epilepsy. OBJECTIVE, PATIENTS AND METHODS: Different demographic and clinical data, collected upon questionnaire completion from 146 patients suffering from epilepsy, were sorted out and integrated in the present research analyses with the objective to determine the possible correlation of collected data and compliance level recorded in the observed patients. RESULTS AND DISCUSSION: Generally, the subjects took pretty the prescribed therapy regularly: in 62% of subjects the compliance level was recorded as good, in 23% as satisfactory, and in the remaining 15% as unsatisfactory. The following factors were identified as possible predictors of the less precise adherence to the prescribed therapeutic regimen (p<0.01): regular consumption of alcohol, medical treatment of 6 or more years, and three or more daily drug doses. The correlation between the greater number of prescribed anti-epileptic medicines and lower compliance level (p=0.05) was also assessed. The study revealed a tendency towards lower compliance level in patients aged below 30. Surprisingly, the same tendency was observed in the subjects with more thoroughly controlled epileptic condition. In spite of different experiments aimed to improve the regularity in taking the prescribed therapy, the issue of non-compliance still poses a considerable obstacle to the more successful treatment of epileptic patients.

[Recommendations for care of patients with cerebral accident. Part One: Organization of care for patients with cerebral accidents, treatment of cerebral accident and neurorehabilitation]. / Preporuke za zbrinjavanje bolesnika s mozdanim udarom. Prvi Dio: Organizacija skrbi za bolesnike s mozdanim udarom, lijecenje mozdanog udara i neurorehabilitacija.

Stroke is the leading cause of disability in modern society. In developed countries stroke is the second or the third cause of death, and in Croatia it is the leading cause of death. Therefore, stroke is not only a great medical, but also economic burden. Figures show that the incidence of stroke in transitional countries is increasing, so the epidemic of stroke could be expected in the forthcoming years. The Croatian Society for Neurovascular Disorders of the Croatian Medical Association and the Croatian Stroke Society wrote the recommendations for stroke management. The first part presents the recommendations for organization of stroke care, stroke treatment and neurorehabilitation, and the second part will present the recommendations for prevention of stroke.

[Recommendations for management of patients with cerebral stroke. Part Two: Primary and secondary prevention of cerebral stroke]. / Preporuke za zbrinjavanje bolesnika s mozdanim udarom. Drugi Dio: Primarna i sekundarna prevencija mozdanog udara.

Despite the enormous progress done in the course of last years in diagnosis, treatment and rehabilitation of stroke patients, prevention is still main strategy in approaching the stroke. After the comprehensive review of the organization of stroke care, treatment and neurorehabilitation of stroke patients, this part shows the recommendations of the Croatian Society for Neurovascular Disorders of the Croatian Medical Association and the Croatian Stroke Society for primary and secondary prevention of stroke.

The significance of immunohistochemical expression of merlin, Ki-67, and p53 in meningiomas.

Meningiomas are one of the most common CNS tumors whose appearance is closely linked to NF2 gene product merlin. Tumor markers Ki-67 and p53 play established role in tumor progression which should be analyzed in close association with merlin expression. The aim of this study was to investigate the immunohistochemical expression of merlin in meningiomas, correlation with Ki-67 and p53, and to determine the association of these results with histologic grade and subtype. The histologic sections of 170 patients with totally resected meningiomas, between January 2000 and December 2010, were classified according to WHO, immunohistochemically stained for Ki-67, p53, and merlin, and analyzed using light microscope. Ki-67 median was 5.6 times higher in group of patients with negative merlin than in those with positive merlin (P=0.05). Statistically significant correlation of merlin with p53 was found (P<0.001). Merlin expression between 2 combined groups (meningothelial/secretory and fibroblastic/transitional) was statistically significant (P=0.002). By comparing merlin expression and p53 levels, statistically significant difference was found (P=0.017). In the group with positive merlin and negative p53 as well as positive merlin and low p53, meningothelial/secretory subtypes of meningiomas were more common. In combination of negative merlin and negative p53 as well as negative merlin and high p53, there were more meningiomas of fibroblastic/transitional subtype. There was no statistically significant correlation between merlin and tumor grade (P=0.420). There is undeniable influence of merlin on the development and the proliferative ability of meningioma subtypes. Significant role of p53 pathway was confirmed.

General recommendations for the management of aneurysmal subarachnoid hemorrhage.

Subarachnoid hemorrhage is a neurologic emergency and a detrimental cerebrovascular event with a high rate of death and complications. Recommendations have been developed and based on literature search, evaluation of the results of large international clinical trials, collective experience of the authors, and endorsed by the Croatian Society of Neurovascular Disorders, Croatian Society of Neurology including Section for Neurocritical Care, Croatian Neurosurgical Society, Croatian Society for Difficult Airway Management and Croatian Medical Association. The aim of these guidelines is to provide current and comprehensive recommendations and to assist physicians in making appropriate decisions in the management of subarachnoid hemorrhage. Evidence based information on the epidemiology, risk factors and prognosis, as well as recommendations on diagnostic work up, monitoring and management are provided, with regard to treatment possibilities in Croatia.

Recommendations for the management of medical complications in patients following aneurysmal subarachnoid hemorrhage.

These are evidence based guidelines for the management of medical complications in patients following aneurysmal subarachnoid hemorrhage, developed and endorsed by the Croatian Society of Neurovascular Disorders, Croatian Society of Neurology including Section for Neurocritical Care, Croatian Neurosurgical Society, Croatian Society for Difficult Airway Management and Croatian Medical Association. They consist of recommendations for best monitoring, medical treatment and interventions based on the literature, evaluation of the results of large international clinical trials, and collective experience of the authors.

Correlation analysis of visual analogue scale and measures of walking ability in multiple sclerosis patients.

Walking limitation assessment in multiple sclerosis patients (MSPs) is a demanding task, especially in the clinical setting. The aim of this study is to correlate the visual analogue scale (VAS), a simple method for measuring subjective experience, with measures of walking ability used in clinical research of MS. The study included 82 ambulatory MSPs who have resided in the local community. The applied measures of walking ability were the following: the single-item and patient-rated Walking Ability Visual Analogue Scale (WA-VAS), the Expanded Disability Status Scale (EDSS), the 25-foot walk test (25FWT), the Six Spot Step Test (SSST), the 2 min timed walk (2 min TW), the Multiple Sclerosis Walking Scale-12 (MSWS-12), and step activity monitor accelerometer (SAM) during 7 day period. The SAM analysis included the average daily step count, the average steps/min of the highest 1 min of a day, and the average steps/min of the highest continuous 60 min of a day. The WA-VAS scores significantly and strongly correlated with EDSS (ρ = 0.679, P < 0.001), 25FWT (ρ = 0.606, P < 0.001), SSST (ρ = 0.729, P < 0.001), 2 min TW (ρ = -0.643, P < 0.001), MSWS-12 (ρ = 0.746, P < 0.001), average daily step count (ρ = -0.507, P < 0.001), average steps/min of the highest 1 min of a day (ρ = -0.544, P < 0.001), and average steps/min of the highest continuous 60 min of a day (ρ = -0.473, P < 0.001). Correlations between WA-VAS and measures of walking ability used in clinical research of MS were satisfactory. The results obtained in this research indicate that the WA-VAS could be an instrument for simple measurement of walking limitations in MSPs in the clinical setting.