Objective:

To assess TUG as an objective measure of function in patients with CIDP in active and remission disease states.

Background:

CIDP is an immune-mediated peripheral nerve disorder with varied phenotypic presentations, marked most often by progressive or relapsing symmetric proximal and distal weakness and numbness with findings of areflexia evolving over a time period of eight weeks or more. Treatment decisions are benefited by monitoring objective outcome measures to guide medication management. While validated outcome measures for CIDP exist, such as the INCAT scale, I-RODS, grip dynamometry, or the CAP-PRI, none specifically address gait. The TUG test, which measures the time it requires to rise from a seated position, ambulate a specified distance, turn and then return to a seated position, has shown promise in capturing gait difficulties in CIDP and has been validated in other neurological conditions, including Lambert-Eaton myasthenia.

Design/Methods:

Single TUG values were collected at a single time point comparing patients in an active (36 patients) versus remission (36 patients) disease state as classified by CIDP Clinical Disease Activity Status (CDAS).

Results:

Active CIDP patients included CDAS classification levels of 3 to 5 while remission CIDP patients included CDAS classification of 1 and 2. The active CIDP group demonstrated an average single TUG time of 10.8 seconds while the remission CIDP group demonstrated an average single TUG time of 8.24 seconds. Based on this limited data from a single time point of measurement, there is a statistically significant difference between the active and remission disease groups (p=0.026). Grip strength, MRC sum score, and I-RODS disability scores also statistically favored the remission group over the active group.

Conclusions:

These observations provide preliminary evidence that the TUG may be a useful assessment of gait in CIDP patients that correlates with disease activity status as well as other measures of strength and disability.