Measurement Characteristics and Clinical Utility of the 29-Item Multiple Sclerosis Impact Scale

      The Multiple Sclerosis Impact Scale (MSIS-29) is a 29-item self-report measure comprised of 20 items associated with a physical scale and 9 items associated with a psychological scale.1 Items question patients (or their proxies) about the impact of multiple sclerosis (MS) on day-to-day life in the last 2 weeks. All items have 5 response options from 1 (not at all) to 5 (extremely). Each of the 2 scales are scored by summing the responses across items, then converting to a 0 to 100 scale, where 100 indicates greater impact of disease on daily function (worse health). The items were selected via a standardized psychometric process: generating a large item pool from patient interviews and professional judgment, then winnowing down to the current items based on pilot and field testing.1 Reliability and validity evidence have been obtained in multiple samples of people with MS from disability levels of 0 to 9.5 on the Expanded Disability Status Scale. The MSIS-29 is responsive to intervention, with a change score of about 8 on the physical scale or about 6 on the psychological scale having moderate to high sensitivity and specificity for patients, indicating whether they had improved or not. A 7-member MS Outcome Measure Task Force of the neurology section of the American Physical Therapy Association highly recommends this measure for use in this population across disability levels and practice settings (
      This abbreviated summary provides a review of the psychometric properties of the MSIS-29. A full review of the MSIS-29 and 62 other measures for patients with MS can be found at Reviews of nearly 200 other instruments for patients with various health conditions can be found at
      Please address all correspondence to Gail Widener, PT, PhD at Samuel Merritt University ( [email protected] ) or Diane Allen, PT, PhD at University of California San Francisco/San Francisco State University ( [email protected] )
      • 1.
        Hobart J, Lamping D, Fitzpatrick R, Riazi A, Thompson A. The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure. Brain 2001;124(Part 5):962-73.
      • 2.
        Hoogervorst ELJ, Zwemmer JNP, Jelles B, Polman CH, Uitdehaag BMJ. Multiple Sclerosis Impact Scale (MSIS-29): relation to established measures of impairment and disability. Mult Scler 2004;10:569-74.
      • 3.
        Riazi A, Hobart JC, Lamping DL, Fitzpatrick R, Thompson AJ. Multiple Sclerosis Impact Scale (MSIS-29): reliability and validity in hospital based samples. J Neurol Neurosurg Psychiatry 2002;73:701-4.
      • 4.
        Mills RJ, Young CA. The relationship between fatigue and other clinical features of multiple sclerosis. Mult Scler 2011;17:604-12.
      • 5.
        Gray O, McDonnell G, Hawkins S. Tried and tested: the psychometric properties of the multiple sclerosis impact scale (MSIS-29) in a population-based study. Mult Scler 2009;15:75-80.
      • 6.
        van der Linden FAH, Kragt JJ, Klein M, van der Ploeg HM, Polman CH, Uitdehaag BMJ. Psychometric evaluation of the multiple sclerosis impact scale (MSIS-29) for proxy use. J Neurol Neurosurg Psychiatry 2005;76:1677-81.
      • 7.
        van der Linden FAH, Kragt JJ, Hobart JC, et al. The size of the treatment effect: do patients and proxies agree? BMC Neurology 2009;9:12.
      • 8.
        Costelloe L, O'Rourke K, Kearney H, et al. The patient knows best: significant change in the physical component of the Multiple Sclerosis Impact Scale (MSIS-29 physical). J Neurol Neurosurg Psychiatry 2007;78:841-4.
      • 9.
        McGuigan C, Hutchinson M. The multiple sclerosis impact scale (MSIS-29) is a reliable and sensitive measure. J Neurol Neurosurg Psychiatry. 2004;75:266-9.
      • 10.
        Ramp M, Khan F, Misajon RA, Pallant JF. Rasch analysis of the Multiple Sclerosis Impact Scale MSIS-29. Health Qual Life Outcomes 2009;7:58.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary's publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors' employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, or the United States Department of Education. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (grant no. H133B090024).