The EXOPULSE Study - a Database for Routine Follow-up of Clinical Outcomes

Change in balance will be assessed using the 14-item Berg Balance Scale (BBS) which has good psychometric properties in Patients with Multiple Sclerosis (concurrent validity, interrater reliability). The scale rates the balance using 56 points, with higher scores indicating better balance abilities. A score equal to or below 45 is commonly associated with risk of fall across the literature.

Change in walking velocity will be assessed with TUG. Patients have to stand up from a chair when they hear the verbal instruction "go", walk a distance of 3 meters, turn around, walk back to the chair and sit down. Timing starts with the verbal instruction "go' and stops when the patients return to the seated position. The score consists of the time taken to complete the test activity, measured in seconds.

The 10mWT is used to assess the change in walking speed in meters/second (m/s) over a short distance.

The change in pain will be assess with NRS. NRS measures the subjective intensity of pain, where 0=no pain and 10=worst pain imaginable.

The change in quality of life will be assessed with EQ-5D, which is an instrument that evaluates the generic quality of life. Designed as a self-completion questionnaire, it embodies two components, a health state description followed by an evaluation.The respondent classifies his or her prevailing state of health by selecting one of three different levels of problem severity within each of five health domains.

The FIQR evaluates the function, overall impact and symptoms of fibromyalgia over the last 7 days.

The Fibromyalgia Impact Questionnaire (FIQ) is a well-established and commonly used instrument to evaluate Fibromyalgia patients. The FIQR is a revised version of the FIQ, that has the same 3 domains, i.e. function, overall impact and symptoms. The FIQR also consists of modified function questions as well as questions on memory, tenderness, balance and environmental sensitivity. All questions are graded on a 0-10 numeric scale.

The Box and Block Test (BBT) measures unilateral gross manual dexterity in patients with neurological diagnoses. Patients are scored based on the number of blocks transferred from one compartment to the other compartment in 60 seconds

The MSWS-12 is a self-report measure of the impact of MS on the individual's walking ability. It contains 12 questions with Likert-type responses and has a recall period of 2 weeks. The psychometric properties of the MSWS-12 have been extensively evaluated in diverse MS populations in both community and hospital settings, with demonstration of internal consistency, high reliability and validity, and good generalizability. The MSWS-12 is less prone to floor and ceiling effects than are other tools, suggesting adequate assessment of the impact of walking impairment across the range of disability.

The WPI is based on a standardized questionnaire. Patients are asked in which regions of the body they have experienced pain in the past seven days. In total, the WPI measures pain in 19 defined body regions or pain zones. It is supposed to be used in combination with the Symptom Severity Scale.

SSS calculates severity scores of a number of Fibromyalgia-related symptoms. Together, the WPI and SSS can be used as diagnostic criteria for Fibromyalgia.