Validity of the shuttle walk test as a functional assessment of walking ability in individuals with polyneuropathy.

PURPOSE: This study assessed the validity of the shuttle walk test (SWT) to evaluate walking ability in patients with polyneuropathy. METHODS: Forty-one patients with chronic idiopathic axonal polyneuropathy (CIAP) and 49 patients with multifocal motor neuropathy (MMN) performed both the 10-meter walk test (10MWT) and the SWT. Face validity was assessed by evaluating whether patients considered both tests to reflect their walking ability (Likert scale: 1 = not at all, 10 = very well). Concurrent validity was determined by Spearman rank-correlation analyses performed on the outcomes of both tests. RESULTS: Mean (SD) scores for how well the 10MWT and SWT reflected daily walking ability were 6.8 (1.3) and 7.4 (1.6) (p = 0.117) in patients with CIAP and 6.9 (1.2) and 7.9 (1.0) (p = 0.001) in patients with MMN, respectively. Correlation scores between both tests ranged from -0.70 to -0.82, except for 18 patients with MMN with a "normal" walking speed at the 10MWT (-0.21). CONCLUSION: The SWT seems a valid instrument for assessing walking ability in individuals with CIAP and MMN. Moreover, the SWT seems to be useful for investigating the symptoms elicited by walking long distances and may be more sensitive to changes when compared to the 10MWT. Implications for Rehabilitation Patients with polyneuropathy mainly experience problems when walking long distances. The 10-meter walk test does not possess sufficient psychometrics to diagnose walking abilities in these circumstances. The shuttle walk test is a valid instrument for assessing walking ability in individuals with polyneuropathy and might be the preferred instrument of choice when compared to the 10-meter walk test.

Pain in patients with chronic idiopathic axonal polyneuropathy.

BACKGROUND/AIMS: Pain in patients with chronic idiopathic axonal polyneuropathy (CIAP) has never been studied in detail. The aim of the study was to investigate the pain experienced by patients with CIAP, and to determine whether pain is associated with health-related quality of life (HRQoL). METHODS: The McGill Pain Questionnaire (MPQ) and the RAND-36 were used in a cross-sectional study. RESULTS: Sixty-three of 91 patients with CIAP reported experiencing pain, describing it as nagging (56%) and annoying (52%). Of these patients, 27 were classified in a subgroup with neuropathic pain (median VAS = 33 mm), 25 in a subgroup with non-neuropathic pain (median VAS = 34 mm), and 11 in a mixed-pain subgroup (median VAS = 25 mm). Non-neuropathic pain was as common and as painful as neuropathic pain. Pain was strongly associated with the physical functioning domain of the RAND-36 in patients in the mixed pain subgroup (r = -0.71, p < 0.05). CONCLUSION: Neuropathic and non-neuropathic pain syndromes should be distinguished in patients with CIAP who experience pain, to enable appropriate tailoring of treatment.

Functioning of patients with multifocal motor neuropathy.

Patients with multifocal motor neuropathy (MMN) have slowly progressive, predominantly distal asymmetric limb weakness without sensory loss. While previous studies have investigated the impact of MMN on body functions and structures, relatively little is known about the impact of patients' weakness on daily functioning. The aim of the present cross-sectional study, involving 47 patients with MMN, was to evaluate determinants of patients' functioning. Most patients showed not only muscle weakness but also fatigue, limited dexterity, and limited walking ability. Regression models showed that age, hand aids, and muscle strength scores together explained 54% of the variance in dexterity scores, which in turn explained 8% of the variance in patients' scores for autonomy indoors. Age, the use of walking aids, and muscle strength scores together explained 58% of the variance in walking ability scores, which in turn explained 18% of the variance in patients' scores for autonomy indoors and 7% of the variance in patients' scores for autonomy outdoors. Assessment of determinants of patient functioning may make it possible to tailor interventions to address these aspects and thereby improve patients' functioning in daily life.

Functioning of patients with chronic idiopathic axonal polyneuropathy (CIAP).

Although patients with Chronic Idiopathic Axonal Polyneuropathy (CIAP) report a slow deterioration of sensory and motor functions, the impact of this deterioration on daily functioning has not yet been investigated in detail. The first aim of this cross-sectional study involving 56 patients with CIAP was, therefore, to assess patients' functioning with use of the International Classification of Functioning, Disability and Health (ICF). The second aim was to find determinants of walking ability, dexterity, and autonomy. Fatigue and limited walking ability were present in most patients and differed considerably. In regression models, age, muscle strength, and fatigue together explained 63% of the variance in walking ability, which by itself explained almost 50% of the variance in patients' autonomy indoors and outdoors (42% and 49%, respectively). Muscle strength and sensory function scores together explained 30% of the variance in dexterity scores, which in turn explained only 13% of the variance in autonomy indoors. The diminished autonomy of patients with CIAP might be improved by reducing fatigue, by means of training, and by improving walking ability.

Functional health status of patients with chronic inflammatory neuropathies.

The functioning of 12 patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and 18 patients with multifocal motor neuropathy (MMN) was evaluated to obtain health profiles and appropriate clinimetric instruments. Assessment was made in a cross-sectional study by means of a performance-based body function test (hand-held dynamometry), two performance-based activity tests (10-m walk test and Berg balance scale), a self-reported activity test (Canadian Occupational Performance Measure), and a self-reported functioning test (sickness impact profile 68). In both patient groups, CIDP and MMN, specific health profiles were manifest. A clear relationship between body function, activities, and functioning was not found. Therefore, to assess a patient with inflammatory neuropathy, it is recommended to assess body function as well as activities and functioning and to select appropriate clinimetric instruments specific for each type of neuropathy.

The responsiveness of the ten-meter walking test and other measures in patients with hemiparesis in the acute phase.

The responsiveness of the Ten-Meter Walking Test (10 MWT) for assessing the walking ability of patients with hemiparesis in the acute phase was evaluated. To put this into perspective, the responsiveness of two other measures, the Berg Balance Scale (BBS) and the Motricity Index (MI) were evaluated as well. Nineteen patients with hemiparesis due to stroke or cerebral tumour in the acute phase were recruited to this study. To measure its responsiveness, the 10 MWT was performed three times a week, and the BBS and the MI performed twice a week. The responsiveness of all tests was computed using the Effect Sizes (ES) and Standardized Response Means (SRM). The ES for the 10 MWT was 1.17 and the SRM was 1.68. The ES and SRM of the BBS were 0.59 and 0.99. The ES and SRM of the MI were 0.27 and 0.96. The results of this study indicate that the 10 MWT is a responsive assessment tool, and appears to be more responsive than other commonly used tests.