title: Linguistic and psychometric validation of the MSSS-88 questionnaire for patients with multiple sclerosis and spasticity in Germany.
abstract: BACKGROUND
  Multiple sclerosis (MS) is an inflammatory disease where many of the patients suffer from spasticity impacting their quality-of-life. The purpose of this paper was to linguistically validate and psychometrically test the Multiple Sclerosis Spasticity Scale (MSSS-88) in German speaking MS patients.
  
  
  METHODS
  The study had two stages: 1) forward/backward translations of the original MSSS-88 scale into German, discussions with MS-experts and cognitive debriefings with MS patients; 2) psychometric evaluation of the German version. Data collection took part in an observational multi-centre study in Germany (MOVE2).
  
  
  RESULTS
  The German translation of the MSSS-88 scale was discussed with three MS-experts; followed by two cognitive debriefing sessions with 12 MS patients. For psychometric evaluation the MSSS-88 was filled in by 87 MS patients with a mean age of 50.2 ± 10.4 years; 26.4% of them had severe spasticity. Data quality was acceptable. Missing data for items of the MSSS-88 were low (range 0-5.75%). Psychometric testing of the MSSS-88 revealed excellent values for reliability and validity. Significant differences between groups regarding severity, grading, type and self-ratings of MS-spasticity and sleep disturbances were found. Sensitivity to change could be demonstrated for the MSSS-88 in the group of MS patients treated with cannabinoid oromucosal spray vs. non-treated patients. In the treated group significant changes with a moderate effect size were found for 'muscle spasms', 'emotional health' and 'pain/discomfort'. No significant changes could be detected in the non-treated group.
  
  
  CONCLUSIONS
  Preliminary evidence from this small study supports reliability, validity, and responsiveness of the German version of the MSSS-88 for measuring the impact of spasticity in MS.
authors: Thomas
authors: T
authors: Henze
authors: Institute of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, 20246, Germany. s.mackensen@uke.uni-hamburg.de.
authors: Sylvia
authors: S
authors: von Mackensen
authors: Gerald
authors: G
authors: Lehrieder
authors: Uwe K
authors: UK
authors: Zettl
authors: Carmen
authors: C
authors: Pfiffner
authors: Peter
authors: P
authors: Flachenecker
mesh_terms: D000328:Adult; D000368:Aged; D003469:Culture; D005260:Female; D005858:Germany; D006801:Humans; D008037:Linguistics; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009128:Muscle Spasticity / Q000175:diagnosis* / Q000209:etiology; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014177:Translations