How Responsive Is the Five Time Sit-to-Stand in Person with Multiple Sclerosis?

Research Objectives: The purpose of this study was to identify the Five Time Sit-to-Stand's (FTSTS) responsiveness and ability to predict falls in persons with MS (PwMS).

Design: FTSTS was measured at initial exam along with the activities of balance confidence (ABC) scale. FTSTS was remeasured within 14 days with no interventions in between. Test-retest reliability coefficient was calculated (ICC) and used in determining the standard error of measurement (SEM) and minimal detectable change (MDC) for the FTSTS. FTSTS scores were correlated (Pearson’s r) with the ABC to determine if a cutoff score for fall risk or need for further assessment could be determined using ABC scores.

Setting: Outpatient physical therapy clinic within large, urban community setting

Participants: 33 participants (23 female, mean age 45, SD±10) with a diagnosis of multiple sclerosis; convenience sample

Interventions: Not applicable

Main Outcome Measures: Five Time Sit-to-Stand; Activity specific Balance Confidence Scale

Results: ICC reliability coefficient (.84) yielded an SEM of 2.26 and MDC95 of 6.3 seconds. FTSTS and ABC scores were poorly correlated (p <.05, r=-.36). However, there was a moderate correlation between ABC scores and FTSTS difference between test and retest (p <.05, r=-.67). Patients that had greater change between test and retest FTST tended to have lower ABC scores.

Conclusions: The MDC in PwMS tended to be higher than those established in other populations. This may have been attributed to the disease instability, baseline fatigue, or confounding impairments. The MS EDGE recommendation in PwMS appears to lack performance-based outcomes, and subsequently the data to support statistical change. The findings within this study add data to this body of research, and should support further investigation into performance-based outcomes in PwMS. The disease fluctuation within MS may also explain the lower self efficacy with balance, raising the concern for potential falls risk.

Author(s) Disclosures: No conflict of interest