Exploring the association between outcome measures to guide clinical management in patients with amyotrophic lateral sclerosis.
Michelle J Sanfilippo, Mary E Layshock, Leslie Keniston
PMID 35937622WHAT IT FOUND
A self-reported three-question mobility score of 9 or less may indicate fall risk in ALS patients when physical testing is too demanding.
This subscale tracked functional decline better than the total ALS rating scale.
Key findings
01The Gross Motor Subscale (GMS) of the ALSFRS-R showed a strong negative correlation with the Timed Up and Go test, explaining 67% of the TUG score.
02A GMS score of 9 or less is postulated to indicate an increased risk of falls, corresponding to a TUG score of 13.5 seconds.
03The total ALSFRS-R score did not significantly correlate with gait velocity, whereas the GMS subscale did, suggesting subscales are more useful for tracking specific mobility changes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only 28 participants, limiting the generalizability of the findings. Data were collected from a single rural multidisciplinary clinic, which may have unique features not representative of other settings. The study did not assess inter-rater or intra-rater reliability of the TUG test. Variability in the number and frequency of clinic visits due to disease progression may affect longitudinal comparisons. The postulated GMS cutoff of 9 for fall risk is based on a correlation equation and requires further validation.
Declared interests
There are no conflicts of interest to disclose.
The easy way to misread this
Do not assume the GMS score of 9 is a validated diagnostic threshold for falls. This is a proposed cutoff derived from a small observational study correlating self-report with the TUG test. It requires further validation before being used as a standalone clinical decision rule.