Reliability and Validity of the Glittre Activities of Daily Living Test in Multiple Sclerosis Patients
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Observational [Patient Registry]

Summary: 
      Patients with Multiple Sclerosis (MS) have reduced functional capacity due to clinical
      symptoms of the disease, resulting in decreased participation in daily living activities and
      reduced quality of life. Evaluation of functional capacity and activities of daily living is
      very important in order to determine appropriate rehabilitation programs and increase the
      participation of patients in daily life activities. However, although there are many scales
      evaluating functional capacity and activities of daily living in people with disabilities,
      there is no specific assessment scale specific to MS patients. Therefore, this study was
      planned to investigate whether the Glittre Daily Living Activities (ADL) Test, which was
      developed to measure functional capacity in chronic obstructive pulmonary disease, is a valid
      and reliable measurement tool in MS patients. For this purpose, a total of 51 participants
      (25 MS patients and 26 healthy participants) evaluated with Glittre ADL Test.

      The relationship between Glittre ADL Test and 6-minute walk test, Notthingham Extended Daily
      Living Activities Index, Multiple Sclerosis Quality of Life Scale, Fatigue Severity Scale,
      Balance Assessment Systems Test (MiniBEST Test), Extended Disability Status Scale and
      5-repetition sit-to-stand test evaluated with Pearson or Spearman correlation coefficient.
      For the known group validity, the difference between the patient and control groups compared
      with the test of the difference between the two means. For reliability, test retest
      performed. Reliability evaluated with the intraclass correlation coefficient.

      Hypothesis 1: Glittre ADL Test results in MS patients and healthy subjects are different.

      Hypothesis 2: Glittre ADL Test is reliable in MS patients.

      Hypothesis 3: Glittre ADL Test is valid for evaluating functional exercise capacity in MS
      patients.
    

Detailed description: 
      Multiple Sclerosis (MS) is a chronic, inflammatory disease characterized by demyelination,
      myelin damage, axonal loss and gliosis in the Central Nervous System (CNS). MS symptoms vary
      according to the size of the lesion and its location in the CNS. Clinical symptoms are
      generally: spasticity, fatigue, muscle weakness, tremor, pain, sensory disturbances, bladder
      bowel problems, cognitive disorders, depression and sleep disorders. With the progression of
      the disease, the performance in daily living activities gradually decreases, affecting the
      quality of life negatively. Maintaining aerobic capacity in chronic diseases such as MS is
      very important for independence in daily living activities. Functional exercise capacity of
      MS patients decreases with the effect of symptoms and sedentary lifestyle. The decrease in
      aerobic capacity can manifest itself with a decrease in walking distance or speed, or a
      limitation in daily living activities. Decline in aerobic capacity is also associated with
      many factors such as increased risk of cardiovascular disease, decreased cognitive functions
      and health-related quality of life. Therefore, aerobic capacity measurement is one of the
      important physiological measurements in terms of evaluating the existing functional status of
      individuals and preparing rehabilitation programs appropriately for individuals.

      Cardiopulmonary exercise tests (CPET) are accepted as the gold standard in the evaluation of
      aerobic capacity. These measurements have some limitations that limit their use, such as the
      high cost of equipment and the need for a well trained team. Today, submaximal tests,
      questionnaires or scales are widely used as an alternative to CPET in evaluating functional
      exercise capacity. Since most daily life activities are at the submaximal level, submaximal
      tests can better determine the functional levels of individuals in daily living activities.

      In order to evaluate functional capacity in Chronic Obstructive Pulmonary Disease (COPD),
      activities similar to daily life activities were selected and the Glittre Daily Living
      Activities (ADL) Test was developed. It has been shown that the Glittre ADL Test is reliable
      and valid in evaluating functional exercise capacity in COPD, as well as reflecting the
      performance in daily living activities for this disease group. The activities in the Glittre
      ADL Test are those that require the use of both the lower and upper extremities. An important
      advantage of the test is that the test can reflect functional capacity as well as providing
      information about performance in daily life activities and that the use of all extremities
      can be observed during the test.

      In this study, the reliability and validity of the Glittre ADL Test in MS patients was
      investigated. For the criterion validity of the Glittre ADL Test, the correlation with the
      6-minute walk test (6MWT) was examined. Patient and control groups were compared for known
      group validity. Test-retest method was used to determine the reliability of Glittre ADL Test.
      Intra-observer reliability was evaluated by intraclass correlation coefficient (ICC). The
      relationship between Glittre ADL Test scores and lower extremity muscle strength, limitation
      of daily living activities, balance, quality of life, fatigue and disease severity was
      investigated. Correlations between the time to complete the Glittre ADL Test and the 5
      Repetition Sit To Stand Test completion time, Nottingham Extended Activities of Daily Living
      Scale, Mini Balance Evulation Systems Test, Multiple Sclerosis Quality of Life 54 scale,
      Fatigue Severity Scale and Expanded Disability Status Scale scores were examined.
    

Intervention name(s): Measurement of functional exercise capacity
Intervention type(s): Other
Intervention description(s): The Glittre Activities of Daily Living (ADL) Test was used to evaluate functional exercise capacity.
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Volunteers of the patients who applied to Hacettepe University Neurology Department,
        diagnosed with MS by specialist physician and referred to Hacettepe University Faculty of
        Health Sciences Physiotherapy and Rehabilitation Department for physiotherapy and
        rehabilitation program were included in the study.
      
Keywords: Multiple sclerosis; Glittre ADL test; Functional capacity assesment