Actual Reality: A New Approach to Functional Assessment in Persons With Multiple Sclerosis

Goverover Y, O'Brien AR, Moore NB, DeLuca J. Actual Reality: a new approach to functional assessment in persons with multiple sclerosis. Arch Phys Med Rehabil 2010;91:252-60. Objective: To examine the use of an innovative approach for assessing everyday life activities of people with multiple sclerosis (MS): Actual Reality. Actual Reality is a performance-based assessment approach that involves the use of the internet to perform real, everyday life activities. Design: A between-subjects design. Setting: Outpatient rehabilitation institute. Participants: Persons (n=21) with clinically definite MS and healthy controls (HCs) (n=18) without any reported neurologic disabilities participated in this study. Participants were between the ages of 21 to 60 years, and the sample consisted of volunteer sample. Interventions: Not applicable. Main Outcome Measures: Participants were asked to access the internet to purchase airline tickets for a round trip flight and were administered the Minimal Assessment of Cognitive Functioning in Multiple Sclerosis. Participants also completed questionnaires to assess quality of life (Functional Assessment of Multiple Sclerosis), functional status (Functional Behavior Profile), and prior Internet experience. Results: The MS group displayed significantly more difficulties than the HC group in accurately and independently completing. the Actual Reality task primarily because of cognitive impairment. Self-report of quality of life and functional status were not correlated with Actual Reality performance in the group of people with MS. However, the self-report measures were significantly associated with affective symptomatology. Conclusions: These results provide initial evidence supporting the use of the Actual Reality approach in assessing persons with MS performing everyday life activities. Actual Reality is a significant step forward in increasing the sensitivity, accessibility, and relevancy of functional assessments in people with cognitive and physical disabilities.