# MScope: A Reliable Battery for Functional Status Assessment in Multiple Sclerosis
## 2 Materials and Methods
### Participants  
Forty-six PwMS (45.1 \(\pm\) 9.0 years, 156.8 \(\pm\) 31.0 cm, and 75.1 \(\pm\) 15.7 kg) volunteered in this study (see Supplementary File S1). The following criteria were used to determine which patients would be included in the study: The diagnosis of multiple sclerosis was made in accordance with the criteria set by [PERSON] et al. [24] (dissemination in space, dissemination in time, use of oligoclonal bands, and exclusion of alternative diagnosis); patients were required to be at least 18 years of age; the degree of disability was evaluated using the Expanded Disability Status Scale (EDSS), with a maximum score of 5; patients were deemed to be in a state of clinical stability, having exhibited no MS relapses over the preceding six months; it was required that no changes in disease-modifying treatment had been made in the previous six months, or that the patients were not undergoing any treatment; in order to be eligible for inclusion in the study, patients must have undergone an MRI scan within the past year, and the results must demonstrate the absence of inflammatory activity, as evidenced by the absence of new T2 lesions or gadolinium-enhancing lesions; the provision of informed consent in writing is a prerequisite for participation.  
Figure 1: MScope: Battery of structural, neuromuscular, and functional tests. (1) Muscle mass assessment; (2) handgrip strength; (3) timed up-and-go test; (4) 5-repetition sit-to-stand test; (5) 60 s sit-to-stand test; (6) 10 m walking test; (7) isometric squat test; (8) isometric leg extension test; (9) 6-min walking test.  
The exclusion criteria for this study were as follows: patients who reported a moderate or higher level of physical activity according to the International Physical Activity Questionnaire (IPAQ-2018), patients who were pregnant or breastfeeding, and the presence of other diagnosed concomitant conditions that would limit physical exercise. In the event of disease relapse during the assessment period, continued participation in the study was subject to individual consideration. All participants completed both measurement sessions.  
Before data collection, an a priori power analysis was conducted to determine the optimal sample size for the reproducibility study. The analysis aimed to achieve a statistical power of 0.95 (95%) with a significance level (\(\alpha\)) of 0.05, ensuring robust results. The calculation assumed a minimum expected Spearman correlation coefficient (rs) of 0.31 between measurements [18], which corresponds to an effect size (dz) of 0.65. To perform this analysis, we used the statistical software G*Power (G*Power 3.1.9.2, Heinrich Heine University Dusseldorf, Dusseldorf, Germany; [[http://www.gpower.hhu.de/](http://www.gpower.hhu.de/)]([http://www.gpower.hhu.de/](http://www.gpower.hhu.de/)) (accessed on 1 November 2024)). Based on these parameters, a minimum sample size of 33 participants was required to achieve sufficient statistical power and precision to evaluate the reliability of the measurements. The selected sample size of 46 participants exceeds this minimum requirement, further strengthening the study's ability to detect meaningful relationships between variables while maintaining statistical rigor.