# MScope: A Reliable Battery for Functional Status Assessment in Multiple Sclerosis
## 5 Conclusions  
This study aimed to evaluate the reliability and validity of the MScope test battery, designed to comprehensively assess functional, structural, and neuromuscular capacity in PwMS. The findings confirm the robustness of this tool, as evidenced by high intra- and inter-day reliability across all measured variables, with ICC values exceeding 0.92 for most tests, indicating consistent performance within and across assessment sessions. However, significant differences were observed in functional tests between sessions, highlighting the sensitivity of these tests to subtle changes in capacity and the potential influence of learning effects. Notably, only the TUG test showed significant heteroscedasticity, although the observed bias was minimal and unlikely to be clinically relevant.  
Neuromuscular and structural evaluations demonstrated strong reliability and minimal variability, with non-significant differences in Bland-Altman and heteroscedasticity analyses, reinforcing their stability for clinical and research applications. Additionally, ultrasound-based muscle thickness measurements showed excellent intra-day and test-retest reliability, supporting the use of ultrasound as a practical and accessible method for monitoring muscle health, particularly in populations at risk of sarcopenia and dynapenia such as PwMS.  
Future research should address the current limitations by including patients with a broader range of disabilities, achieving balanced gender representation, and incorporating familiarization trials to minimize potential learning effects. In summary, the MScope test battery provides a reliable and valid tool for evaluating functional, structural, and neuromuscular parameters in PwMS. Its application can enhance clinical assessment, guide personalized rehabilitation protocols, and contribute to advancing the understanding of neuromuscular function and frailty in PwMS.  
The following supporting information can be downloaded at [[https://www.mdpi.com/article/10.3390/app15010011/s1](https://www.mdpi.com/article/10.3390/app15010011/s1)]([https://www.mdpi.com/article/10.3390/app15010011/s1](https://www.mdpi.com/article/10.3390/app15010011/s1)): Table S1: Demographic and clinical baseline characteristics of participants. Data are expressed as mean \(\pm\) SD or absolute value (%); Table S2: [PERSON] and Altman BIAS, 95% Limits of Agreement and heteroscedasticity.  
Conceptualization, D.L., I.J.-F. and S.M.-I.; methodology, I.J-F. and S.M.-I.; formal analysis, S.L.-O. and J.P.-F.; data curation, D.L., J.P.-F. and C.G.-C.; writing--original draft preparation, D.L. and S.M.-I.; writing--review and editing, A.C.-M., N.T., C.G.-C. and S.L.-O.; visualization, S.L.-O.; supervision, S.M.-I. and N.T.; project administration, A.C.-M. and S.M.-I. All authors have read and agreed to the published version of the manuscript.  
This research received no external funding. Research by C.G-C. is funded by Miguel de Cervantes European University, Department of Health Sciences, i+HeALTH Strategic Research Group. I.J-F. was supported by the Ministry of Education of Spain (23 CO1/009080).  
The study was conducted in accordance with the Declaration of Helsinki and approved by the hospital Ethics Committee of Hospital Clinico Universitario de Valladolid (protocol code PI-GR-23-3292).  
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.  
The data presented in this study are available on request from the corresponding authors.  
The authors would like to thank all participants who contributed to this study.  
The authors declare no conflicts of interest.