Objective: To examine the reliability, validity and interpretability of four measures in assessing the severity of balance dysfunction and short term treatment benefits on balance among people with multiple sclerosis and secondary cerebellar ataxia. The findings of this study will inform the core set of measures of balance for the target population.

Background: Previous work by this team reported the use the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, the posture and gait sub-component of the International Co-operative Ataxia Rating Scale (PG-ICARS) and gait, stance and sit sub-components of the Scale for the Assessment and Rating of Ataxia (SARABal) as appropriate measures of balance for cerebellar ataxia. However formal validation of the measures is required before recommending for clinical practice.

Methods: This cross-sectional observational multi-centre study tested 60 participants with multiple sclerosis and ataxia, aged between 18 and 65 and were able to walk with or without support. In addition to the measures of balance the Barthel Index, Expanded Disability Status Scale (EDSS), full scales of the SARA and ICARS were assessed and disease duration recorded to estimate validity. Assessments were video-recorded and repeat assessments to estimate reliability were completed through observation of video recordings.

Results: Reliability was strong for all four measures, ICC ranged between 0.95 and 0.99. Internal consistency was moderate to strong for all four measures (α range 0.72-0.94), moderate to strong correlation between the measures of balance (ρS range 0.72-0.85) and there was a poor to moderate correlation with disease severity (EDSS), functional independence (Barthel Index) and disease duration (ρS range -0.37 to 0.76). Minimal Clinically Important Difference (MCID) was derived for BBS (3), PG-ICARS (2) and SARABal (2). Measures were able to discriminate between assistive walking device users and non-users.

Conclusions: All four measures showed strong reliability and acceptable validity, owing to the item repetition in scoring the PG-ICARS and the TUG, the BBS and SARABal are recommended for balance assessment in clinical practice for people with multiple sclerosis and cerebellar ataxia.

Completed study has yet to be presented. The manuscript will be submitted for publication with the APMR journal in February 2016.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/core-set-of-measures-of-balance-for-people-with-multiple-sclerosis-and-cerebellar-ataxia/