Self-perceived physical functioning and health status among fully ambulatory multiple sclerosis patients

We investigated the
self-perceived health status among
multiple sclerosis (MS) patients
with no or mild disability according
to the Expanded Disability Status
Scale (EDSS) and the impact of
self-rated physical functioning.A
sample of fully ambulatory (EDSS
≤ 3.5) consecutive patients with MS
was included after screening for
major cognitive impairment. The
EDSS was used to measure nervous
system signs or disability, and the
self-rated health status was assessed
using the SF-36 Health Survey.
The normative SF-36 data for
the general population of Italy were
used for comparison. The 197 MS
patients analyzed (150 women and
47 men) had significantly lower
mean SF-36 scores than the general
population, except for bodily pain.
The scores did not differ significantly
by gender. The same analysis
performed on a subsample of 105
patients (79 women and 26 men)
with minimal disability in one
functional system (EDSS ≤ 2.0)
yielded similar results. EDSS was
weakly correlated with the physical
functioning subscale and explained
only 2% of the variance in the
physical functioning subscale. The
regression of the physical functioning
subscale on the other seven SF-
36 subscales was significantly lower
among MS patients than in the
general population for all subscales,
except for role limitation
due to physical health problems
and social functioning.Neither disease
course nor duration correlated
significantly with SF-36 subscales.
The SF-36 physical functioning
subscale seemed to indicate physical
functioning more sensitively
than EDSS. These findings should
encourage the implementation of
specific strategies aimed at improving
the quality of the self-perceived
health status already in the early
disease stage.