title: Does ability to walk reflect general functionality in inflammatory neuropathies?
abstract: The "ability to walk" is considered a benchmark for good clinical recovery and prognosis, particularly in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). However, it has never been determined whether being "able to walk" represents general functionality. The purpose of this study was to examine whether the ability to walk outside independently reflects general functional improvement in patients with GBS, CIDP, and gammopathy-related neuropathy (MGUSP). A total of 137 patients with newly diagnosed (or relapsing) GBS (55), CIDP (59), and MGUSP (23) were serially examined (1-year). Predefined arbitrary cut-offs (so-called patients' Functional-Acceptable-Clinical-Thresholds [FACTs]) were taken at the 50th, 75th, and 90th percentile of the Inflammatory-Rasch-built-Overall-Disability-Scale (I-RODS(©) ). We determined the proportion of patients able to walk outside independently that reached the postulated cut-offs. A mean total of 85%, 39%, and 12% of all patients able to walk reached 50th, 75th, and 90th percentile thresholds, respectively. These findings were not neuropathy type related. Our findings show that assessing only one construct of functionality (e.g., walking ability) does not reflect the full scope of daily/social functional deficits perceived by patients. The ability to walk shows a patient is doing better, but not necessarily doing well. The I-RODS(©) bypasses these limitations.
authors.affiliation: Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.
authors.forename: Thomas H P
authors.initials: TH
authors.lastname: Draak
authors.affiliation: Department of Neurology, St. Elizabeth's Medical Centre, Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Gorson
authors.affiliation: Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Els K
authors.initials: EK
authors.lastname: Vanhoutte
authors.affiliation: Department of Neurology, Havenziekenhuis, Rotterdam, The Netherlands.
authors.forename: Sonja I
authors.initials: SI
authors.lastname: van Nes
authors.affiliation: Department of Neurology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands.
authors.forename: Pieter A
authors.initials: PA
authors.lastname: van Doorn
authors.affiliation: Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Cornblath
authors.affiliation: Department of Neurology, Rudolf Magnus Institute of Neuroscience University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Leonard H
authors.initials: LH
authors.lastname: van den Berg
authors.affiliation: Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.
authors.forename: Catharina G
authors.initials: CG
authors.lastname: Faber
authors.affiliation: Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.|Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands.
authors.forename: Ingemar S J
authors.initials: IS
authors.lastname: Merkies
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D020275:Guillain-Barre Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000175:diagnosis* / Q000503:physiopathology*; D012720:Severity of Illness Index; D013997:Time Factors; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: inflammatory neuropathies; outcome research