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Abstract Details

A single-center, prospective, cross-sectional study to evaluate the reliability and validity of the modified Manual Muscle Test for persons with multiple sclerosis
Multiple Sclerosis
P16 - Poster Session 16 (5:30 PM-6:30 PM)
9-004
To evaluate the reliability and validity of a new modified manual muscle test (mMMT) for persons with multiple sclerosis (MS), which considered spasticity while testing.
In MS, weakness is mostly associated with spasticity that may interfere with traditional manual muscle testing. mMMT considers spasticity and may provide a less biased outcome. 
This was a single-center, prospective cross-sectional and longitudinal study with a test-retest design. Six testers examined 28 patients with MS. The inter- and intra-rater reliability was evaluated using a one-way random effects ANOVA model. We compared the inter- and intra-rater reliability of the 12-level mMMT with those of the 6-level manual muscle tests that are part of the Neurostatus Expanded Disability Status Scale (EDSS). Additionally, we calculated the correlations between the mMMT and  Neurostatus EDSS and the isometric maximal muscle strength assessed by a hand-held dynamometer. The influence of fatigue and spasticity was evaluated in subgroups using a linear mixed effects model for each test separately.
Both mMMT and Neurostatus EDSS did not reach the limit of intra-class correlation coefficient (ICC) of 0.75 for good interrater reliability. The pooled overall value of the intra-rater reliability of the mMMT (ICC=0.77) and the Neurostatus EDSS (ICC=0.74) were similar.  We did not find any influence of fatigue on the test results. As regards spasticity, we observed a clear difference for the mMMT foot; however, there was no statistical evidence in ICC between the high and low spasticity subgroups. Both tests demonstrated a weak to moderate, positive, monotonous correlation with isometric maximal muscle strength. We observed that the results clearly varied between different muscle groups.
This study demonstrated that the mMMT is a reliable and valid outcome measurement tool to test muscle function in MS patients when the mMMT is applied by one therapist.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
Marcus D'Souza, MD (University-Hospital-Basel) Dr. D'Souza has nothing to disclose.
No disclosure on file