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Multiple%20Sclerosis%20Functional%20Composite%20Timed%2025%20Foot%20Walk%209-Hole%20Peg%20Test%20Paced%20Auditory%20Serial%20Addition%20Test
Multiple%20Sclerosis%20Functional%20Composite%20Timed%2025%20Foot%20Walk%209-Hole%20Peg%20Test%20Paced%20Auditory%20Serial%20Addition%20Test
| Availability |
Freely available on the NMSS website: Multiple Sclerosis Functional Composite (MSFC)
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| Classification |
Core: Friedreich's ataxia (FA)
The Nine Hole Peg Test and Timed 25 Foot Walk are Core for FA
Exploratory: Multiple Sclerosis (MS)
The three assessments that make up the MSFC are Exploratory for MS
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| Short Description of Instrument |
The Multiple Sclerosis Functional Composite (MSFC) is a three-part, standardized, quantitative, assessment instrument for use in MS clinical trials. (Cutter et al, 1999) It was developed by the special Task Force on Clinical Outcomes Assessment, appointed by the National Multiple Sclerosis Society's Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. (Whitaker et al, 1995; Rudick et al., 1996)
The MSFC fulfills three criteria: 1) It is multidimensional and reflects the varied clinical expression of MS across patients and over time; 2) The dimensions change relatively independently over time; 3) One component is a measure of cognitive function.
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| Comments/Special Instructions |
The three components of the MSFC measure leg function/ambulation (Timed 25-Foot Walk) , arm/hand function (Nine Hole Peg Test), and cognitive function (Paced Auditory Serial Addition Test - PASAT). These MSFC component measures were used in MS prior to their being combined into this composite measure. Since its introduction, the MSFC has seen increasing use in both clinical trials and other clinical studies.
This document refers to the original MSFC as the MS Functional Composite has shifted over the years to have different components. Currently, other iterations are being employed. (Drake et al., 2010;Ontaneda et al., 2012)
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| Scoring and Psychometric Properties |
Scoring: The Multiple Sclerosis Functional Composite (MSFC) can produce scores for each of the three individual measures as well as a composite score. In addition, there are a variety of ways to calculate scores depending on the nature of the study and sample. The administration and scoring manual are available to download. (Fischer et al., 2001)
Psychometric Properties: The three measures that make up the MSFC have all been shown to have good inter-rater and test-retest reliability. In addition, there is considerable evidence for their validity and sensitivity to clinically relevant change in MS patients. (Cutter et al., 1999; Fischer et al., 1999)
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| Rationale/Justification |
Strengths: The MSFC provides a versatile assessment method for investigational purposes with the ability to measure patients at various levels of disability.
Weaknesses: The performance on the MSFC is sensitive to practice effects, that is, patients often display poorer performance when first tested due to lack of familiarity with the tasks. If accurate (rather than comparative) assessments of change over time are needed, it is recommended that three or four administrations be given prior to a baseline assessment. (Cutter et al., 1999; Fischer et al., 1999)
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| References |
Key References:
Cutter GR, Baier ML, Rudick RA, Cookfair DL, Fischer JS, Petkau J, Syndulko K, Weinshenker BG, Antel JP, Confavreux C, Ellison GW, Lublin F, Miller AE, Rao SM, Reingold S, Thompson A, Willoughby E. Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain. 1999 May;122 ( Pt 5):871-82.
Fischer JS, Rudick RA, Cutter GR, Reingold SC. The Multiple Sclerosis Functional Composite Measure (MSFC): an integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force. Mult Scler. 1999 Aug;5(4):244-50.
Additional References:
Drake AS, Weinstock-Guttman B, Morrow SA, Hojnacki D, Munschauer FE, Benedict RH. Psychometrics and normative data for the Multiple Sclerosis Functional Composite: replacing the PASAT with the Symbol Digit Modalities Test. Mult Scler. 2010 Feb;16(2):228-37.
Fischer JS, Jak AJ, Kniker JE, Rudick RA, Cutter G. Multiple Sclerosis Functional Composite (MSFC) Administration and Scoring Manual October 2001. Available at: https://nms2cdn.azureedge.net/cmssite/nationalmssociety/media/msnationalfiles/brochures/10-2-3-31-msfc_manual_and_forms.pdf. Accessed 31 July 2023.
Ontaneda D, LaRocca N, Coetzee T, Rudick R; NMSS MSFC Task Force. Revisiting the multiple sclerosis functional composite: proceedings from the National Multiple Sclerosis Society (NMSS) Task Force on Clinical Disability Measures. Mult Scler. 2012 Aug;18(8):1074-80.
Rudick R, Antel J, Confavreux C, Cutter G, Ellison G, Fischer J, Lublin F, Miller A, Petkau J, Rao S, Reingold S, Syndulko K, Thompson A, Wallenberg J, Weinshenker B, Willoughby E. Clinical outcomes assessment in multiple sclerosis. Ann Neurol. 1996 Sep;40(3):469-79.
Rudick R, Antel J, Confavreux C, Cutter G, Ellison G, Fischer J, Lublin F, Miller A, Petkau J, Rao S, Reingold S, Syndulko K, Thompson A, Wallenberg J, Weinshenker B, Willoughby E. Recommendations from the National Multiple Sclerosis Society Clinical Outcomes Assessment Task Force. Ann Neurol. 1997 Sep;42(3):379-82.
Whitaker JN, McFarland HF, Rudge P, Reingold SC. Outcomes assessment in multiple sclerosis clinical trials: a critical analysis. Mult Scler. 1995 Apr;1(1):37-47.
Document last updated August 2023
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