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Continuous In-Home Symptom and Mobility Measures for Individuals With Multiple Sclerosis: A Case Presentation

Newland, Pamela; Kimutis, Alyssa; Salter, Amber; Flick, Louise; Thomas, Florian P.; Rantz, Marilyn; Skubic, Marjorie

Journal of Neuroscience Nursing: August 2017 - Volume 49 - Issue 4 - p 241–246
doi: 10.1097/JNN.0000000000000299
Case Study

ABSTRACT Gait impairment represents one of the most common and disabling symptoms of multiple sclerosis (MS). To identify which temporal or spatial parameters of gait could be used as outcome measures in interventional studies of individuals with MS with different levels of disability, we evaluated characteristics of these parameters in a case study of 3 participants with MS, using 1 case as an exemplar and the other participants as validation. A case study of an exemplar participant was conducted with a 67-year-old woman with secondary progressive MS served as exemplar, with 2 other participants (52 and 55 years old) as validation. The primary outcome measures we used were stride time, stride length, gait velocity, and daily symptoms. Stride length and velocity of gait decreased with increasing pain and fatigue. The step time was significantly longer later in the day, whereas the step length remained the same. Stride length and velocity are associated with the level of fatigue and pain, as well as the time of day. These characteristics and parameters of gait need to be considered in future studies of gait in MS, with particular attention to temporality of occurrence in persons with MS.

Questions or comments about this article may be directed to Pamela Newland, PhD RN CMSRN, at She is an Associate Professor, Goldfarb School of Nursing, Barnes Jewish College, St Louis, MO.

Alyssa Kimutis, RN BSN, is Staff Nurse, St Louis Children Hospital, St Louis, MO.

Amber Salter, PhD, is Assistant Professor, Division of Biostatistics, Washington University School of Medicine, St Louis, MO.

Louise Flick, DrPH MSN MPE, is Professor Emerita of Epidemiology and Nursing, St Louis University, St Louis, MO.

Florian P. Thomas, MD MA PhD, is Director, Multiple Sclerosis Center, and Chairman, Neuroscience Institute, Hackensack University Medical Center, Seton Hall University, South Orange, NJ.

Marilyn Rantz, RN PhD FAAN, is Professor, Sinclair School of Nursing, University of Missouri, Columbia, MO.

Marjorie Skubic, PhD, is Professor, Electrical and Computer Engineering Department, University of Missouri, Columbia, MO.

This work was funded by a pilot grant from the Consortium of Multiple Sclerosis Centers.

The authors declare no conflicts of interest.

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© 2017 American Association of Neuroscience Nurses