A 35-minute examination was completed at an outpatient physical therapy clinic. The patient had her caregiver/niece with her at the time of the initial evaluation and examination session. The caregiver sat off to the side and observed the therapy session as well as offered relevant information regarding the patient when appropriate. The patient was also observed in the standing position from the front, back, left and right. Patient presented with forward flexed posture at the thoracolumbar spine, bilateral flexion of the knees, left patella was slightly deviated laterally from midline, and a wide base of support (feet greater than shoulder width apart). Range of motion (ROM) both active (AROM) and passive (PROM) was assessed bilaterally at
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She ambulated with a forward flexed posture over the rollator, decreased gait speed and stride length and required frequent rest breaks. During the first treatment session she ambulated 60 feet with a rollator and moderate assistance was required. The impact of MS on the patient’s ability to walk was subjectively measured with the twelve item multiple sclerosis walking scale (MSWS-12). For each gait related item a score of 1-5 is selected with 1 meaning no limitation and 5 meaning extreme limitation. The scores for each item are summed and a final score out of 60 is reported with higher score indicating a greater impact on walking ability. MSWS-12 is currently the only qualitative self-reported test to measure walking disability plus other aspects such as running and stair climbing (Kieseier). When the MSWS-12 was taken twice with an interval of ten days excellent test-retest reliability and had a intraclass correlation coefficient (ICC) of .94 (Hobart). For the assessment of walking fatigability, distance limitations and functional capacity the 2-minure walk test (2mWT) was performed by the patient. Due to the high fatigability of the patient the 2mWT was chosen over the 6mWT. The 2mWT is a reasonable alternative for the gold standard 6mWT due to the decreased in assessment time and burden (gijbes and Kieseier). During the 2mWT the individual is asked cover as much distance as possible at maximal walking speed over 2 minutes without any physical assistance. Assistive devices can be used as long as consistency is maintained from test to test. The 2mWT reported with poor interrater and intrarater reliability (gijbes) however, the use of the shorter 2mWT is validated based on the strong association between the 2mWT and 6mWT because of the strong correlation with the first 2 minutes of the 6mWT (gijbes and Kieseier). Difficultly with functional
She ambulated with a forward flexed posture over the rollator, decreased gait speed and stride length and required frequent rest breaks. During the first treatment session she ambulated 60 feet with a rollator and moderate assistance was required. The impact of MS on the patient’s ability to walk was subjectively measured with the twelve item multiple sclerosis walking scale (MSWS-12). For each gait related item a score of 1-5 is selected with 1 meaning no limitation and 5 meaning extreme limitation. The scores for each item are summed and a final score out of 60 is reported with higher score indicating a greater impact on walking ability. MSWS-12 is currently the only qualitative self-reported test to measure walking disability plus other aspects such as running and stair climbing (Kieseier). When the MSWS-12 was taken twice with an interval of ten days excellent test-retest reliability and had a intraclass correlation coefficient (ICC) of .94 (Hobart). For the assessment of walking fatigability, distance limitations and functional capacity the 2-minure walk test (2mWT) was performed by the patient. Due to the high fatigability of the patient the 2mWT was chosen over the 6mWT. The 2mWT is a reasonable alternative for the gold standard 6mWT due to the decreased in assessment time and burden (gijbes and Kieseier). During the 2mWT the individual is asked cover as much distance as possible at maximal walking speed over 2 minutes without any physical assistance. Assistive devices can be used as long as consistency is maintained from test to test. The 2mWT reported with poor interrater and intrarater reliability (gijbes) however, the use of the shorter 2mWT is validated based on the strong association between the 2mWT and 6mWT because of the strong correlation with the first 2 minutes of the 6mWT (gijbes and Kieseier). Difficultly with functional