Association of Urinary Incontinence with Sensory-Motor Performance in Women with Multiple Sclerosis.

INTRODUCTION AND HYPOTHESIS: The relationship between somatosensory and motor components of urinary incontinence in individuals with MS has not been extensively addressed. The study was aimed at investigating the association of urinary incontinence severity with motor and sensory performance in women with multiple sclerosis (MS). METHODS: A cross-sectional single-center prospective study was conducted in 337 women with MS. The severity of MS symptoms was assessed using the SymptoMScreen questionnaire. The urinary incontinence status of the participants was evaluated using the Urinary Incontinence Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7). Physical performance was considered with the Timed Up and Go (TUG) test and the 5-Times Sit-to-Stand (5TSTS) test. In addition, the sensory performance of the individuals with MS was queried using the Somatosensory Amplification Scale (SSAS) and Sensory Sensitivity Scale (SeSS). RESULTS: The UDI-6 (r=0.685, p<0.05) and IIQ-7 (r=0.759, p<0.05) correlated highly with SymptoMScreen. Among the physical performance measures, TUG (r=0.012, p<0.05) and 5TSTS (r=0.096, p<0.05) were weakly associated with UDI-6, but not statistically significantly. Similarly, there was a low correlation between IIQ-7 and TUG (r=-0.005, p<0.05) and 5TSTS (r=0.068, p<0.05). UDI-6 (0.360, p<0.05) and IIQ-7 (0.378, p<0.05) correlated moderately with SASS. On the other hand, SeSS had a low correlation coefficient with UDI-6 (0.305, p<0.05) and IIQ-7 (0.272, p<0.05). CONCLUSIONS: The results revealed that sensory performance was more associated with urinary incontinence in women with MS than physical performance. The urinary incontinence severity was also related to MS symptoms (bladder control, walking, spasticity, stiffness cognitive function). Future studies should consider the potential impact of sensory performance on urinary incontinence and focus on explaining the mechanism behind this relationship.

Opinions, satisfaction and expectations of individuals with multiple sclerosis about telerehabilitation services.

OBJECTIVE: The opinions, satisfaction, and expectations of telemedicine can provide essential data for remote health services in individuals with Multiple Sclerosis (MS). The study aimed to demonstrate the views (barriers-benefits), satisfaction, and expectations of individuals with MS about telerehabilitation services. METHODS: A prospective cross-sectional was conducted with 82 individuals with MS who received telerehabilitation services for at least one year. The participants have completed SymptoMScreen, Beck Depression Inventory (BDI), Telehealth Usability Questionnaire (TUQ), Telemedicine Satisfaction Questionnaire (TSQ), Telehealth Barriers Questionnaire (TBaQ and Telehealth Benefits Questionnaire (TBeQ). RESULTS: As the age of individuals with MS increased, TUQ (r: -0.517, p < 0.001) and TBeQ (r: -0.383, p < 0.001) decreased, while TSQ (r: 0.405, p < 0.001) and TBaQ (r: 0.390, p < 0.001) increased. SymptoMScreen score (r: -0.288, p < 0.05) was weakly associated with TUQ. In addition, TUQ, TSQ, TBeQ, and TBaQ were strongly correlated (p < 0.001). CONCLUSION: In order to improve usability and satisfaction in telerehabilitation services, the age, symptom severity, and education levels of individuals with MS should be considered. Telehealth methods with high usability should be preferred to increase patient satisfaction.

Agreement between video-based clinician-rated tools and patient-reported outcomes on gait assessment in individuals with multiple sclerosis.

PURPOSE: To our knowledge, no studies compared the video-clinician-based tools and patient-reported questionnaires in assessing gait and balance in people with MS (pwMS). The present study investigated the correlation and agreement between video-clinician-based objective measurement tools and patient-reported outcome measures (PROMs) in gait and balance evaluation. METHODS: A prospective cross-sectional study was conducted with 55 pwMS. Video analysis-based gait was evaluated by the Tinetti Gait Assessment (TGA), Gait Assessment and Intervention Tool (GAIT), and Functional Ambulation Classification Scale (FACS) by the clinician. Participants' self-reported gait and balance were assessed with the Multiple Sclerosis Walking Scale-12 (MSWS-12) and Activity-Specific Balance Confidence Scale (ABC). RESULTS: There was a moderate positive correlation between ABC with TGA and FACS (r1: 0.552, r2: 0.510, p < 0.001). ABC was strongly correlated with GAIT (r: - 0.652, p < 0.001). A moderate positive correlation was observed between MSWS-12 with TGA and FACS (r1: - 0.575, r2: - 0.524, p < 0.001). In addition, there was a strong positive correlation between MSWS-12 and GAIT (r: - 0.652, p < 0.001). Clinician-rated tools and PROMs were within the agreement limits regarding the unstandardized beta values p < 0.001). CONCLUSIONS: Clinician-based gait and balance tools demonstrate consistent results with PROMs in pwMS. Considering the low cost and practical use of PROMs, in cases where video-based clinician-based measurements cannot be provided (time, space, and technical inadequacies), questionnaires can provide concordant results at moderate and severe levels compared with objective tools.