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You might worry about things like your legs getting weaker, needing more support to walk, or even having difficulty with simple, everyday tasks like lifting a cup. Your doctor would call this “disability progression”.
Difficulties like these can be part of the progression of MS that you and your doctors are trying to prevent. Different treatment options may be better or worse at slowing down disability progression. Do you know how treatments are put to the test?
How is disability assessed in MS and what does “disability improvement” really mean?
The Kurtzke Expanded Disability Status Scale (EDSS) is widely used in research and by doctors to measure disability progression.1,2 This scale, which goes from 0 (normal brain functioning) to 10 (death), describes disease milestones such as requiring a walking aid (EDSS 7) or a wheelchair (EDSS 8).2 The scale also works backward such that if a patient’s EDSS score gets smaller (e.g., from 6 to 5) this means a better outcome since there is an improvement in ability.4
Disability improvement, therefore, means that a disability has become less severe.
Expanded Disability Status Scale3
While the EDSS is commonly used, there are other ways disability is monitored by doctors and researchers. For example, a timed walking test allows doctors to see if the walking speed has worsened or improved in someone with MS.4
Can MS treatments slow down disability progression?
The timing of therapy is important in slowing down MS disability progression. Researchers have found that patients who start treatment early on, right at the time of MS diagnosis, have better long-term outcomes than patients who start treatment later on, while no treatment at all leads to even worse long-term outcomes.1,5
When considering your treatment plans, ask your doctor if any options can slow or prevent disability progression, or if any options may even improve disability over time. Also, ask your doctor if starting a powerful treatment earlier may help.
Check your knowledge!
What did you learn?
True or false?
EDSS is used to assess disability, with higher scores signifying a reduction in walking impairments.
Not true! While the EDSS scale is used to measure disability, higher scores indicate disease progression. Under an EDSS score of 5, patients can walk without assistance but may have other symptoms such as muscle weakness, speech problems, numbness, etc. With EDSS scores of 5 and above, the patients experience walking difficulties.
When considering your treatment options, you should discuss disability outcomes with your doctor.
True! While the EDSS scale is used to measure disability, higher scores indicate disease progression. Under an EDSS score of 5, patients can walk without assistance but may have other symptoms such as muscle weakness, speech problems, numbness, etc. With EDSS scores of 5 and above the patients experience walking difficulties.
When considering your treatment options, you should discuss disability outcomes with your doctor.
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References:
1. Giovannoni G, et al. Brain health: time matters in multiple sclerosis. Available online at https://www.msbrainhealth.org/recommendations/brain-health-report/. Accessed September 2021.
2. National Multiple Sclerosis Society. Functional System Score (FSS) and Expanded Disability Status Scale (EDSS). Available online at https://www.nationalmssociety.org/For-Professionals/Researchers/Resources-for-MS-Researchers/Research-Tools/Clinical-Study-Measures/Functional-Systems-Scores-(FSS)-and-Expanded-Disab. Accessed July 2022.
3. Multiple Sclerosis Trust. Expanded Disability Status Scale (EDSS). January 2020. Available online at https://mstrust.org.uk/a-z/expanded-disability-status-scale-edss. Accessed July 2022.
4. FAMPYRA Product Monograph. Biogen Canada Inc. January 24, 2022.
5. Miller JR. J Manag Care Pharm. 2004 Jun;10(3 Suppl B):S4-11.
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