Please rotate your device to landscape

For the best learning experience, we recommend to use a desktop device.

Disability progression

Learning objectives

This module was produced during the 2021 quarantine, where filming has been conducted remotely to adhere to social distancing guidelines. For this reason, please forgive a lower production quality than you are used to seeing from us.

This module is intended to help you:

Comprehend the types of mechanisms underlying disability progression
Be aware of different ways to assess disability progression
Be able to implement improvements in the management of disability progression
Recognise the potential impact of disability progression on a patient’s quality of life and understand potential strategies to support patients with the management of MS symptoms

Giovannoni G, et al. Mult Scler Relat Disord 2016;9(Suppl. 1):S5–48.
Embrey N. Nurs Stand 2014;29:49–58.
Jones E, et al. BMC Health Serv Res 2016;16;294.
Compston A, et al. Lancet 2008;372:1502–17.
Meyer-Moock S, et al. BMC Neurol 2014;14:58.
Rudick RA, et al. Arch Neurol 2010;67:1329–35.
Kurtzke JF. Neurology 1983;33:1444–52.
Demir S. Noro Psikiyatr Ars 2018;55(Suppl. 1):S66–8.
Kalincik T, et al. Brain 2015;138:3287–98.
LaRocca NG, et al. Mult Scler 2018;24:1469–84.
Angelini L, et al. J Neurol 2020;267:2897–909.
Renner A, et al. J Neuropsychol 2020;14:347–69.
Nolan RC, et al. J Neuroophthalmol 2018;38:202–9.
Balcer LJ, et al. Mult Scler 2017;23:734–47.
D’Amico E, et al. Mult Scler Relat Disord 2019;33:61–6.
Tarlov AR. JAMA J Am Med Assoc 1989;262:925–30.
Penner IK, et al. Mult Scler 2009;15:1509–17.
Beck AT, et al. J Pers Assess 1996;67:588–97.
Atkinson MJ, et al. Health Qual Life Outcomes 2004;2:12.
Neurologybytes. Managing disability progression. 2018. https://www.neurologybytes.com/events-cme/34th-congress-of-the-european-committee-for-treatment-and-research-in-multiple-sclerosis-ectrims/meet-the-experts---francesco-patti/. Accessed June 2020.
Thompson AJ, et al. Lancet 2018;391:1622–36.
Hedström AK, et al. Neurology 2014;82:865–72.
Hempel S, et al. Mult Scler 2017;23:525–33.
Manouchehrinia A, et al. Brain 2013;136:2298–304.
Degelman ML, et al. Mult Scler Relat Disord 2017;17:207–16.
Handel AE, et al. PLoS One 2011;6:e16149.
Nourbakhsh B, et al. Contin (Minneap Minn) 2019;25:596–610.
Dobson R, et al. Eur J Neurol 2019;26:27–40.
D’Amico E, et al. Expert Rev Neurother 2017;17:123–7.
D’Amico E, et al. Funct Neurol 2016;31:21–3.
Ford S. Nursing Times. Nurses reluctant to discuss disability with MS patients. 2017. https://www.nursingtimes.net/news/reviews-and-reports/exclusive-nurses-reluctant-to-discuss-disability-with-ms-patients-19-07-2017/". Accessed June 2020.
MS Trust and Sanofi Genzyme. The missing pieces: Identifying the gaps in care and conversations in MS. Adv Clin Neurosci Rehabil 2017. https://www.acnr.co.uk/2017/07/the-missing-pieces-identifying-the-gaps-in-care-and-conversations-in-ms/". Accessed September 2020.
Amatya B, et al. Cochrane Database Syst Rev 2017;2017:1–11.
Kidd T, et al. PLoS One 2017;12:e0185931.
Krieger S, et al. Clin Neurol Neurosurg 2014;119:6–16.
MS Trust. Expanded Disability Status Scale (EDSS) 2020. Available at https://www.mstrust.org.uk/a-z/expanded-disability-status-scale-edss. Accessed September 2020.
Balcer LJ, et al. Brain 2015;138:11–27.
Benedict RH, et al. Mult Scler 2017;23:721–33.
Goldman MD, et al. Neurology 2019;93:E1921–31.

Disability progression

Disability progression can impact a patient’s quality of life. This module outlines our current understanding of the mechanisms underlying disability progression, and looks at ways to prevent, assess and manage it.

Length
12 min course

Job code
NPS-TPE-NP-00176

Which of the following is NOT a patient-reported outcomes measure (PROM) that can be used to assess patients with MS?

Select the correct answer(s)

The Symbol Digit Modalities Test (SDMT) is an objective screening instrument that detects cognitive impairment by measuring concentration and decision-making.¹

Axonal damage ultimately
leads to what?

Select the correct answer(s)

Axonal damage ultimately leads to neurodegeneration.¹

Which of the following are considered important factors for the
self-management of MS? A patient’s …

Select the correct answer(s)

All but ‘ability to use technology’ are considered important factors for self-management.¹

Match the symptom and a relevant patient-reported outcome measure.

In the 2017 study with UK MS nurses, in what range was the proportion who stated that out of all the ways to assess disability, they use ‘visual appearance’ the most?

Select the correct answer

A study in 2017 found that 96% of UK MS nurses stated that out of all the ways to assess disability, they use ‘visual appearance’ the most.^1,2

Which of the following does the MSFC currently fail to evaluate?

Select the correct answer(s)

The MSFC currently lacks a visual dimension.¹ However, several studies have suggested adding low-contrast visual acuity (a test of visual impairment) to the composite of tests.^2,3

Disability progression

Please note you are now leaving Neurologybytes.com and being redirected to a different website not operated by Teva Pharmaceuticals.

Please rotate your device to landscape

For the best learning experience, we recommend to use a desktop device.

Disability progression

Learning objectives

Please click continue to proceed.

What leads to cumulative disability over time?

Select the correct answer(s)

Please click continue to proceed.

Which of the following instruments canbe used to evaluate cognitive function?

Select the correct answer(s)

Which of the following is NOT a patient-reported outcomes measure (PROM) that can be used to assess patients with MS?

Select the correct answer(s)

The Symbol Digit Modalities Test (SDMT) is an objective screening instrument that detects cognitive impairment by measuring concentration and decision-making.1

Axonal damage ultimately leads to what?

Select the correct answer(s)

Axonal damage ultimately leads to neurodegeneration.1

Which of the following are considered important factors for the self-management of MS? A patient’s …

Select the correct answer(s)

All but ‘ability to use technology’ are considered important factors for self-management.1

Match the symptom and a relevant patient-reported outcome measure.

In the 2017 study with UK MS nurses, in what range was the proportion who stated that out of all the ways to assess disability, they use ‘visual appearance’ the most?

Select the correct answer

A study in 2017 found that 96% of UK MS nurses stated that out of all the ways to assess disability, they use ‘visual appearance’ the most.1,2

Which of the following does the MSFC currently fail to evaluate?

Select the correct answer(s)

The MSFC currently lacks a visual dimension.1 However, several studies have suggested adding low-contrast visual acuity (a test of visual impairment) to the composite of tests.2,3

Congratulations!

You have completed module 7

Links and downloadable elements

Disability progression

The benefits of early DMT in relapsing–remitting MS

Vaccination and MS

Which of the following instruments can
be used to evaluate cognitive function?

The Symbol Digit Modalities Test (SDMT) is an objective screening instrument that detects cognitive impairment by measuring concentration and decision-making.¹

Axonal damage ultimately
leads to what?

Axonal damage ultimately leads to neurodegeneration.¹

Which of the following are considered important factors for the
self-management of MS? A patient’s …

All but ‘ability to use technology’ are considered important factors for self-management.¹

A study in 2017 found that 96% of UK MS nurses stated that out of all the ways to assess disability, they use ‘visual appearance’ the most.^1,2

The MSFC currently lacks a visual dimension.¹ However, several studies have suggested adding low-contrast visual acuity (a test of visual impairment) to the composite of tests.^2,3