The Cardiovascular
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Disease Steps for Multiple Sclerosis

Simple ambulation-based staging of MS-related disability.

Disease Steps for Multiple Sclerosis
Disease Step
ResultDisease Step 0

Ambulation-based disability staging; correlates closely with the Expanded Disability Status Scale (EDSS) but is faster to obtain.

When to use

  • Rapid, ambulation-based tracking of MS-related disability in clinic or by telephone/self-report.
  • As a pragmatic alternative to the EDSS when a full neurological Functional Systems exam is impractical.

Formula

Single clinician (or patient-reported) rating from 0 (normal) to 6 (wheelchair-confined), based primarily on ambulatory status.

Pearls and pitfalls

  • Correlates strongly with EDSS (r ~0.94 in the original validation) while requiring far less examination time.
  • A patient-determined version (PDDS) allows self-report by telephone or questionnaire.

References

  1. Hohol MJ, Orav EJ, Weiner HL. Disease steps in multiple sclerosis: a longitudinal study comparing disease steps and EDSS to evaluate disease progression. Mult Scler. 1999;5(5):349-354.