Abstract
The objective of this study was to explore whether it is possible to describe based on the International Classification of Functioning, Disability and Health (ICF) relevant aspects of functioning and disability affected in multiple sclerosis (MS) as well as environmental factors relevant to persons with MS. The specific aim was to identify most relevant ‘Body functions’, ‘Body structures’, ‘Activities and participation’, as well as ‘Environmental factors’ in patients with MS using the ICF. Additionally, different MS forms were compared with respect to the identified problems. A multi-centre study was conducted in an empirical cross-sectional design. Data from 205 individuals with MS were collected in rehabilitation centres: disease related data, socio-demographic data, single interviews based on the Extended ICF Checklist and a patient questionnaire including ratings on general health and functioning status, Beck Depression Inventory II (BDI-II) and Comorbidity Questionnaire (SCQ). The 129 ICF categories identified represent a comprehensive classification of functioning in MS from the clinical perspective. Differences between MS forms were observed for several ICF categories, EDSS, general health and functioning status, but not for BDI and SCQ. The study showed that it is possible to describe based on the ICF the spectrum in functioning and disability affected in MS as well as environmental factors relevant to persons with MS.
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Amato MP, Zipoli V, Portaccio E (2006) Multiple sclerosis-related cognitive changes: a review of cross-sectional and longitudinal studies. J Neurol Sci 245:41–46
Avasarala J, Cross A, Trinkaus K (2003) Comparative assessment of yale single question and beck depression inventory scale in screening for depression in multiple sclerosis. Multiple Scler 9:307–310
Beck A, Steer R, Brown G (1996) Manual for beck depression inventory-II—manual. The Psychological Corporation, San Antonio
Beck A, Ward C, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychia 4:53–63
Beiske A, Svensson E, Sandanger I, Czujko B, Pedersen E, Aarseth J, Myhr K (2008) Depression and anxiety amongst multiple sclerosis patients. Eur J Neurol 15:329–345
Clingerman E, Stuifbergen A, Becker H (2004) The influence of resources on perceived functional limitations among women with multiple sclerosis. J Neurosci Nurs 36:312–321
Ewert T, Fuessl M, Cieza A, Anderson C (2004) Identification of the most common problems in patients with chronic conditions using the ICF checklist. J Rehabil Med Suppl 44:22–29
Flachenecker P, Rieckmann P (2004) Health outcome in multiple sclerosis. Curr Opin Neurol 17:257–261
Fraser C, Polito S (2007) A comparative study of self-efficacy in men and women with multiple sclerosis. J Neurosci Nurs 39:102–106
Green G, Todd J, Pevalin D (2007) Biographical disruption associated with multiple sclerosis: using propensity scoring to assess the impact. Soc Sci Med 65:524–535
Hastie T, Tibshirani R, Friedman J (2008) The elements of statistical learning: data mining, inference, and prediction. New York
Hautzinger M, Keller F, Kühner C (2006) BDI-II—beck depressions-inventar 2. Auflage Harcourt Test Services, Frankfurt/Main
Heesen C, Böhm J, Reich C, Kasper J, Goebel M, Gold S (2008) Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable. Multiple Scler 14:988–991
Johansson S, Ytterberg C, Claesson I, Lindberg J, Hillert J, Andresson M, Widén Holmqvist L, von Koch L (2007) High concurrent presence of disability in multiple sclerosis. J Neurol 254:767–773
Julian L, Merluzzi N, Mohr D (2007) The relationship among depression, subjective cognitive impairment, and neuropsychological performance in multiple sclerosis. Multiple Scler 13:81–86
Kesselring J, Beer S (2005) Symptomatic therapy and neurorehabilitation in multiple sclerosis. Lancet Neurol 4:643–652
Kira J, Tobimatsu S, Goto I, Hasuo K (1993) Primary progressive versus relapsing remitting multiple sclerosis in Japanese patients: a combined clinical, magnetic resonance imaging and multimodality evoked potential study. J Neurol Sci 117:179–185
Kobelt G, Berg J, Lindgren P, Fredrikson S, Jönsson B (2006) Costs and quality of life of patients with multiple sclerosis in Europe. J Neurol Neurosurg Psychiatry 77:918–926
Lobentanz I, Asenbaum S, Vaas K, Sauter C, Klösch G, Kollegger H, Kristoferitsch W, Zeitlhofer J (2004) Factors influencing quality of life in multiple sclerosis patients: disability, depressive mood, fatique and sleep quality. Acta Neurol Scand 110:6–13
MacAllister W, Krupp L (2005) Multiple sclerosis-related fatique. Phys Med Rehabil Clin N Am 16:483–502
Marrow T (2007) The costs and consequences of multiple sclerosis relapses: a managed care perspective. J Neurol Sci 15:S39–S44
Nortvedt M, Riise T, Fruqård J, Mohn J, Bakke A, Skår A, Nyland H, Glad S, Myhr K (2007) Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis. Multiple Scler 13:106–112
Osborne T, Jensen M, Ehde D, Hanley M, Kraft G (2007) Psychological factors associated with pain intensity, pain-related interference, and psychological functioning in persons with multiple sclerosis and pain. Pain 127:52–62
Polman C, Reingold S, Edan G, Filippi M, Hartung H-P, Kappos L, Lublin F, Metz L, McFarland H, O’Connor P, Sandberg-Wollheim M, Thompson A, Weinshenker B, Wolinsky J (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald criteria”. Ann Neurol 58:840–846
Poser C, Paty D, Scheinberg L, McDonald W, Davis F, Ebers G, Johnson K, Sibley W, Silberberg D, Tourtellotte W (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231
Potagas C, Giogkaraki E, Koutsis G, Mandellos D, Tsirempolou E, Sfagos C, Vassilopoulos D (2008) Cognitive impairment in different MS subtypes and clinically isolated syndromes. J Neurol Sci 267:100–106
Putzki N, Katsarava Z, Vago S, Diener H, Limmroth V (2008) Prevalence and severity of multiple-sclerosis-associated fatigue in treated and untreated patients. Eur Neurol 59:136–142
Rashid W, Hadjiprocopis A, Davies G, Griffin C, Chard D, Tiberio M, Altmann D, Wheeler-Kingshott C, Tozer D, Thompson A, Miller D (2008) Longitudinal evaluation of clinically early relapsing-remitting multiple sclerosis with diffusion tensor imaging. J Neurol 255:390–397
Rot U, Mesec A (2006) Clinical, MRI, CSF and electrophysiological findings in different stages of multiple sclerosis. Clin Neurol Neurosurg 108:271–274
Sá M (2007) Psychological aspects of multiple sclerosis. Clin Neurol Neurosurg (in press)
Sangha O, Stucki G, Liang M, Fossel A, Katz J (2003) The self-administered comorbidity questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 49:156–163
Simioni S, Ruffieux C, Bruggimann L, Annoni J, Schluep M (2007) Cognition, mood and fatigue in patients in the early stage of multiple sclerosis. Swiss Med Wkly 137:496–501
Thompson A (2004) Overview of primary progressive multiple sclerosis (PPMS): similarities and differences from other forms of MS, diagnostic criteria, pros and cons of progressive diagnosis. Multiple Scler 10:S2–S7
Turpin K, Carroll L, Cassidy J, Hader W (2007) Deterioration in the health-related quality of life of persons with multiple sclerosis: the possible warning signs. Multiple Scler 13:1038–1045
Ustun B, Chatterji S, Bickenbach J, Konstansjek N, Schneider M (2001) The World Health Classification, ICIDH-2 checklist 2.1a clinical form for international classification of functioning, disability and health. ICF, Geneva
Vleugels L, Pfennings L, Pouwer F, Cohen L, Ketelaer P, Polman C, Lankhorst G, van der Ploeg H (1998) Psychological functioning in primary progressive versus secondary progressive multiple sclerosis. Br J Med Psychol 71:99–106
WHO (2004) Atlas: country resources for neurological disorders. WHO, Geneva
WHO (2001) International Classification of Functioning, Disability and Health: ICF. WHO, Geneva
Yuan M, Lin Y (2006) Model selection and estimation in regression with grouped variables. J R Stat Soc B 68:49–67
Acknowledgment
The project was supported by the Hertie Foundation (“Gemeinnützige Hertie-Stiftung”) as a cooperative project between the Classification, Terminology and Standards (CTS) Team of WHO, Department of Neurorehabilitation, Valens Rehabilitation Centre, Valens (Switzerland), the Institute for Health and Rehabilitation Sciences, ICF Research Branch of WHO at the Ludwig-Maximilian University Munich (Germany), the Multiple Sclerosis International Federation (MSIF), and the International Society of Physical Medicine and Rehabilitation (ISPMR). For the conduction of the statistical analysis the authors thank Cornelia Oberhauser, Institute for Health and Rehabilitation Sciences (IHRS), ICF Research Branch of WHO at the Ludwig-Maximilian University, Munich (Germany). The authors further thank all participating clinics and rehabilitation centers involved in data collection, the University Hospital Zurich (Switzerland), the Swiss Multiple Sclerosis Society, Zurich (Switzerland) and the Neurological Rehabilitation Center Quellenhof, Bad Wildbad (Germany).
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Holper, L., Coenen, M., Weise, A. et al. Characterization of functioning in multiple sclerosis using the ICF. J Neurol 257, 103–113 (2010). https://doi.org/10.1007/s00415-009-5282-4
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DOI: https://doi.org/10.1007/s00415-009-5282-4