Does ability to walk reflect general functionality in inflammatory neuropathies?
Por:
Draak, THP, Gorson, KC, Vanhoutte, EK, van Nes, SI, van Doorn, PA, Cornblath, DR, van den Berg, LH, Faber, CG, Merkies, ISJ, Querol, L., van Schaik, Ivo N.
Publicada:
1 jun 2016
Resumen:
The ability to walk is considered a benchmark for good clinical recovery and prognosis, particularly in patients with Guillain-Barre syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). However, it has never been determined whether being able to walk represents general functionality. The purpose of this study was to examine whether the ability to walk outside independently reflects general functional improvement in patients with GBS, CIDP, and gammopathy-related neuropathy (MGUSP). A total of 137 patients with newly diagnosed (or relapsing) GBS (55), CIDP (59), and MGUSP (23) were serially examined (1-year). Predefined arbitrary cut-offs (so-called patients' Functional-Acceptable-Clinical-Thresholds [FACTs]) were taken at the 50th, 75th, and 90th percentile of the Inflammatory-Rasch-built-Overall-Disability-Scale (I-RODS (c)). We determined the proportion of patients able to walk outside independently that reached the postulated cut-offs. A mean total of 85%, 39%, and 12% of all patients able to walk reached 50th, 75th, and 90th percentile thresholds, respectively. These findings were not neuropathy type related. Our findings show that assessing only one construct of functionality (e.g., walking ability) does not reflect the full scope of daily/social functional deficits perceived by patients. The ability to walk shows a patient is doing better, but not necessarily doing well. The I-RODS (c) bypasses these limitations.
Filiaciones:
Draak, THP:
Univ Med Ctr Maastricht, Dept Neurol, Maastricht, Netherlands
Gorson, KC:
Tufts Univ, Sch Med, Dept Neurol, St Elizabeths Med Ctr, Boston, MA 02111 USA
Vanhoutte, EK:
Maastricht Univ, Med Ctr, Dept Clin Genet, NL-6202 AZ Maastricht, Netherlands
van Nes, SI:
Havenziekenhuis, Dept Neurol, Rotterdam, Netherlands
van Doorn, PA:
Erasmus MC, Dept Neurol, Rotterdam, Netherlands
Cornblath, DR:
Johns Hopkins Sch Med, Dept Neurol, Baltimore, MD USA
van den Berg, LH:
Univ Med Ctr Utrecht, Rudolf Magnus Inst Neurosci, Dept Neurol, Utrecht, Netherlands
Faber, CG:
Univ Med Ctr Maastricht, Dept Neurol, Maastricht, Netherlands
Merkies, ISJ:
Univ Med Ctr Maastricht, Dept Neurol, Maastricht, Netherlands
Spaarne Hosp, Dept Neurol, Hoofddorp, Netherlands
Querol, L.:
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
van Schaik, Ivo N. :
Universiteit van Amsterdam, Amsterdam, Netherlands
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