Analysis of health-related quality of life and muscle impairment in individuals with amyotrophic lateral sclerosis using the Medical Outcome Survey and the Tufts Quantitative Neuromuscular Exam

Objective: The Tufts Quantitative Neuromuscular Exam (TQNE) is commonly used to assess the rate of disease progression in individuals with amyotrophic lateral sclerosis (ALS). The Medical Outcome Study Short Form (SF-36) is a general method to assess health-related quality of life (HRQL). This study examined the relationship between the TQNE and SF-36, established the reliability and responsiveness of each, and contrasted the HRQL between individuals with ALS and the general population. Design: Subjects (31) completed the SF-36 and TONE within 1 week to determine reliability. Subjects (17) also completed both the TONE and SF-36 each month for 1 year after diagnosis of ALS to establish the relationship between the two assessment tools. Setting: A primary care university teaching hospital. Patients: Thirty-one subjects with an age range of 27 to 76 years (mean 59.1, SD 10.32), recently diagnosed with ALS. Results: Each test was highly reliable and responsive. The intraclass correlations (2, 1) were consistently higher for the TQNE (.93 to .98) than for the SF-36 (.57 to .90). Changes in physical function were correlated to changes in lower extremity force megascores (.48). Conclusion: Both the TQNE and the SF-36 are reliable and responsive and appear important in characterization of patient status after ALS is diagnosed. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.