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Patient-performed functional tests were found to be reliable, scalable options for assessing muscle function in idiopathic inflammatory myopathies.

Manual muscle testing (MMT8)—the current gold standard for assessing muscle function in patients with idiopathic inflammatory myopathies—has faced considerable criticism. New research using a 3-pronged approach demonstrated that patient-performed functional tests are reliable, scalable options for MMT8, with gait analysis providing complementary insights.

Anna-Maria Liphardt, PhD, and colleagues aimed to compare MMT8 with inertial sensor-based gait analysis to evaluate patient-performed functional tests guided by shared decision-making and investigate adherence to electronic patient-reported outcomes (PROs) in a small cohort of individuals with idiopathic inflammatory myopathies. The findings were reported in Arthritis Research & Therapy.

The study included 28 patients (67.9% women; mean age, 57.4 years), with the majority (32.1%) diagnosed with antisynthetase syndrome. MMT8 was performed at baseline and 3 months.

In addition, inertial-sensor-based gait analysis was completed at baseline, and 2 standardized upper extremity (Modified Barré test, 10-time arm lift test) and 2 lower extremity muscle endurance tests (60-second Sit-to-Stand test, Mingazzini test) were offered as options for patients to select from. Through shared decision-making, each patient selected 1 test for lower and upper extremities and opted to record weekly results on paper or through a medical app.

The researchers analyzed correlations between gait parameters, functional tests, and MMT8 and assessed agreement between patient- and healthcare professional (HCP)–recorded results at baseline and 3 months. They also evaluated responsiveness to change.

They observed moderate correlations between MMT8 and gait parameters such as walking speed (r=0.545; P=0.004) and stride length (r=0.580; P=0.002). All patients selected the Modified Barré test for assessing upper extremity function, and 60.7% of patients chose the Mingazzini test for assessing lower extremity function.

The results showed excellent agreement between patient- and HCP-recorded functional test outcomes at baseline and 3-month follow-up assessments (ranging from 0.99 to 1.00), showing the reliability of self-assessment. Functional tests demonstrated strong correlations with MMT8, particularly for the Mingazzini test (r=0.762; P=0.002). Most patients (82.1%) preferred app-based recording to paper-based recording, and weekly electronic PROs were completed, on average, for 6.9 of 12 weeks (57.1%).

“Patient-performed functional tests are reliable, scalable alternatives to MMT8, with gait analysis providing complementary insights. Digitally supported self-assessments can enhance clinical workflows, remote monitoring, and treat-to-target strategies, empowering patients and improving disease management,” the researchers concluded.

They noted that larger studies are warranted to establish the findings’ broader applicability and potential to improve patient self-management and clinical efficacy.