A classification system to assess the degree of disability in patients with amyotrophic lateral sclerosis
Keywords:
Amyotrophic Lateral Sclerosis, functional measurement, disability, ALSFRS-RAbstract
Objective: Determining the degree of disability in patients with Amyotrophic Lateral Sclerosis (ALS) aids in establishing treatment and rehabilitation guides. The objective of this study is to propose a disability classification system for patients with ALS based on the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R).Materials and methods: a sample of 72 consecutive patients with possible, probable and definite case definition of ALS according to clinical and electrophysiologic criteria were assessed with the ALSFRS-R Spanish Version. A principal component factor analysis was carried out to establish the different components of the scale and to choose the most useful variables. With the chosen
variables, groups of disability were defined. Correlation between these groups of disability and the ALSFRS-R total score, time of disease and muscle strength median was assessed.
Results: Factor analysis showed that three components accounted for 73.5% of variance. One activity was selected from each of these three components. Swallowing, cutting food and handling utensils and walking were selected from factors one, two and three, respectively. Based on these three activities, four groups of disability were defined: dependent in the three activities, independent in one activity, independent in two activities and independent in three activities. Disability groups were statistically correlated with the ALSFRS-R total score (p<0.001) and muscle strength median (p<0.001; r=0.5). There was no correlation between disability group and time of disease.
Conclusion: a four-group disability classification system based on three activities taken from the ALSFRS-R allows rapid assessment of the functional condition of patients with ALS.
References
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2. Cedarbaum JM, Stambler N, Malta E, Fuller C, Hilt D, Thurmond B, et al. The ALSFRSR: a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF ALS Study Group (Phase III). J Neurol Sci 1999 October 31;169(1-2):13-21.
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5. Lechtzin N, Maragakis NJ, Kimball R, Busse A, Hoffman V, Clawson L. Accurate ALSFRS-R scores can be generated from retrospective review of clinic notes. Amyotroph Lateral Scler 2009 August; 10(4):244-247.
6. Campos TS, Rodriguez-Santos F, Esteban J, Vazquez PC, Mora Pardina JS, Carmona AC. Spanish adaptation of the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R). Amyotroph Lateral Scler 2010 October;11(5):475-477.
7. Brooks BR. Functional scales: summary. Amyotroph Lateral Scler Other Motor Neuron Disord 2002;3 Suppl 1:S13-S18.
8. de Carvalho M, Dengler R, Eisen A, England JD, Kaji R, Kimura J, et al. Electrodiagnostic criteria for diagnosis of ALS. Clin Neurophysiol 2008 March; 119(3):497-503.
2. Cedarbaum JM, Stambler N, Malta E, Fuller C, Hilt D, Thurmond B, et al. The ALSFRSR: a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF ALS Study Group (Phase III). J Neurol Sci 1999 October 31;169(1-2):13-21.
3. Castrillo-Viguera C, Grasso DL, Simpson E, Shefner J, Cudkowicz ME. Clinical significance in the change of decline in ALSFRS-R. Amyotroph Lateral Scler 2010;11(1-2):178-180.
4. Kollewe K, Mauss U, Krampfl K, Petri S, Dengler R, Mohammadi B. ALSFRS-R score and its ratio: a useful predictor for ALSprogression. J Neurol Sci 2008 December15;275(1-2):69-73.
5. Lechtzin N, Maragakis NJ, Kimball R, Busse A, Hoffman V, Clawson L. Accurate ALSFRS-R scores can be generated from retrospective review of clinic notes. Amyotroph Lateral Scler 2009 August; 10(4):244-247.
6. Campos TS, Rodriguez-Santos F, Esteban J, Vazquez PC, Mora Pardina JS, Carmona AC. Spanish adaptation of the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R). Amyotroph Lateral Scler 2010 October;11(5):475-477.
7. Brooks BR. Functional scales: summary. Amyotroph Lateral Scler Other Motor Neuron Disord 2002;3 Suppl 1:S13-S18.
8. de Carvalho M, Dengler R, Eisen A, England JD, Kaji R, Kimura J, et al. Electrodiagnostic criteria for diagnosis of ALS. Clin Neurophysiol 2008 March; 119(3):497-503.
How to Cite
1.
Ortiz Corredor F, Mendoza Pulido C, Peña Preciado M. A classification system to assess the degree of disability in patients with amyotrophic lateral sclerosis. Rev. Colomb. Med. Fis. Rehabil. [Internet]. 2012 Apr. 14 [cited 2024 May 19];21(1):14-22. Available from: https://revistacmfr.org/index.php/rcmfr/article/view/3
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