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. 2021 Aug 2;269(3):1282–1297. doi: 10.1007/s00415-021-10674-8

Table 1.

Commonly used tools for the assessment of functional change in individuals with multiple sclerosis

Test Function tested Description Equipment Process Utility Threshold for clinically meaningful change
T25FW [19] Walking disability Measures time (in seconds) to walk 25 feet

Unobstructed open space measuring 25 feet (no turns permitted)

Timer (e.g., stopwatch)

Mechanism for recording scores (e.g., pen and paper)

Assistive walking devices (optional)

Ask individual to walk the distance as quickly and safely as possible, stopping beyond the finish point to avoid a reduction in speed

Repeat once

Routine management and clinical trials 20% change [19, 23, 24]
6MWT [30] Gait Measures distance walked (in meters) in 6 min

Unobstructed open space (turns permitted)

Assistive walking devices may be used

Timer (e.g., stopwatch)

Mechanism for recording score (e.g., pen and paper)

Assistive walking devices (optional)

Ask individual to walk for 6 min at maximal speed Clinical practice and clinical trials 20% change [22]
TUG [39] Basic mobility Measures the time taken (in seconds) to stand from a chair, walk a fixed distance, return, and sit down

2-armed chair positioned in a space that allows a 10-foot walk

Assistive walking devices may be used

Timer (e.g., stopwatch)

Mechanism for recording score (e.g., pen and paper)

Assistive walking devices (optional)

Ask individual to rise from the chair, walk to a mark 10 feet away, turn, and return to a seated position

Repeat (once or twice)

Clinical practice to monitor effects of medical and rehabilitation treatment Improvement of 23–24% and deterioration of 30–31% [40]
9-HPT [50] Dexterity (upper extremity [hand/arm] funsction) Measures time taken (in seconds) or speed (in pegs/second) to complete the task

Table and chair

Shallow container with 9 pegs and a block containing 9 holes for the pegs to fit in

Timer (e.g., stopwatch)

Ask the individual to sit and, using 1 hand, put pegs 1 at a time into the holes as quickly as possible; once completed, ask the individual to remove the pegs (with the same hand) 1 at a time and place back in the container

Repeat once with the same hand

Repeat twice with the other hand

Clinical practice and self-assessment, and as part of the MSFC in clinical trials 20% change [133]
SDMT [65] Cognition (processing speed) Measures time taken (in minutes/seconds) to complete the task

Set of symbols and numbers

Timer (e.g., stopwatch)

Mechanism for recording score (e.g., pen and paper)

Symbol test, including mechanism for recording response (electronic versions of the SDMT may be available)

Give the individual a set of symbols corresponding to a series of numbers

Ask the individual to write down the symbols corresponding to the series of numbers

Clinical practice and trials assessing cognitive processing speed 4-point score change, 10% reduction in score, or change in 0.5 standard deviations [63]
LCLA [76] Visual disability Measures impaired low-contrast vision at multiple letter sizes

Sloan Eye chart

Retro-illuminated cabinet or darkened room

Mechanism for recording score (e.g., pen and paper)

Individual seated 2 m from chart

Individuals read letters aloud top to bottom and left to right

Scores are quantified as the number of letters identified on a Sloan eye chart (maximum 70)

Clinical trials 7-point change [76]

6MWT 6-Minute Walk Test, 9-HPT 9-Hole Peg Test, LCLA low-contrast letter acuity, SDMT Symbol Digit Modalities Test, T25FW Timed 25-Foot Walk, TUG Timed Up and Go