'The illness isn't the end of the road'-Patient perspectives on the initiation of and early participation in a multi-disease, community-based exercise programme.

BACKGROUND: Exercise is the cornerstone of cardiac rehabilitation (CR). Hospital-based CR exercise programmes are a routine part of clinical care and are typically 6-12 weeks in duration. Following completion, physical activity levels of patients decline. Multi-disease, community-based exercise programmes (MCEP) are an efficient model that could play an important role in the long-term maintenance of positive health behaviours in individuals with cardiovascular disease (CVD) following their medically supervised programme. AIM: To explore patients experiences of the initiation and early participation in a MCEP programme and the dimensions that facilitate and hinder physical activity engagement. METHODS: Individuals with established CVD who had completed hospital-based CR were referred to a MCEP. The programme consisted of twice weekly group exercise classes supervised by clinical exercise professionals. Those that completed (n = 31) an initial 10 weeks of the programme were invited to attend a focus group to discuss their experience. Focus groups were transcribed and analysed using reflexive thematic analysis. RESULTS: Twenty-four (63% male, 65.5±6.12yrs) patients attended one of four focus groups. The main themes identified were 'Moving from fear to confidence', 'Drivers of engagement,' and 'Challenges to keeping it (exercise) up'. CONCLUSION: Participation in a MCEP by individuals with CVD could be viewed as a double-edged sword. Whilst the programme clearly provided an important transition from the clinical to the community setting, there were signs it may breed dependency and not effectively promote independent exercise. Another novel finding was the use of social comparison that provided favourable valuations of performance and increased exercise confidence.

Safety, feasibility and effectiveness of the remotely delivered Pulmonary Hypertension and Home-Based (PHAHB) physical activity intervention.

Background: Pulmonary hypertension (PH) is a heterogeneous condition, associated with a high symptom burden and a substantial loss of exercise capacity. Despite prior safety concerns regarding physical exertion, exercise training as a supportive therapy is now recommended for PH patients. Currently, most programmes are hospital-based, which limits accessibility. There is a need to provide alternative approaches for physical activity engagement for PH patients. The aim of this research was to develop, implement and evaluate the safety, feasibility and effectiveness of home-based physical activity intervention for PH. Methods: An entirely remotely delivered home-based physical activity intervention underpinned by behaviour change theory and informed by end-users, was assessed using a single-arm feasibility study design. Participants (n=19; 80% female) with a mean±sd age of 49.9±15.9 years with a diagnosis of PH undertook a 10-week, home-based physical activity intervention with induction training, support materials, telecommunication support, health coaching, exercise training and assessments, all remotely delivered. Training involved respiratory training along with a combination of aerobic and resistance exercises. Results: The intervention was deemed safe as no adverse events were reported. A high level of feasibility was demonstrated as the protocol was implemented as intended, sustained a high level of engagement and adherence and was well accepted by participants in terms of enjoyment and utility. There was a significant improvement in functional capacity, physical activity, exercise self-efficacy and quality of life, between baseline and post-training. Conclusion: The study demonstrates that an entirely remotely delivered home-based physical activity programme is safe, feasible and effective in improving functional capacity, physical activity and quality of life in PH patients.

A two-arm non-randomised trial of MedEx IMPACT: a community-based, physical activity behaviour change intervention for survivors of cancer.

PURPOSE: This two-arm non-randomised trial examined the short- and long-term effects of a usual care (UC) community-based exercise programme (MedEx Move On (MMO)), and UC combined with a physical activity (PA) behaviour change (BC) intervention (MedEx IMproved PA after Cancer Treatement (MedEx IMPACT)) on PA levels, cardiorespiratory fitness (CRF) and quality of life (QoL) among survivors of cancer. METHODS: Cancer survivors referred to MMO were recruited (n = 191; mean age (± SD) 56 (± 10y), 73% female). Eighty-seven participants were assigned to UC, and 104 participants were assigned to the MedEx IMPACT intervention group (MI). UC and MI both received twice-weekly supervised exercise classes for 12-weeks. MI also received an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation during the 12-week programme. Assessments of physical and psycho-social health, including 6-day accelerometry, the 6-min time trial and the Functional Assessment of Cancer Therapy-General QoL questionnaire, were conducted at baseline (T1), post-intervention (T2) and 3 months following programme completion (T3). RESULTS: Linear mixed-model analyses of variance demonstrated significant main effects for time for both groups from T1 to T2 with increases in objectively measured daily steps (p < 0.05), CRF (p < .001) and QoL (p < .01), which were maintained for CRF (p < .001) at T3. MI participants also maintained increases achieved at T2, in steps and QoL, at T3 (p < 0.01). CONCLUSION: Twelve weeks of twice-weekly supervised exercise was effective in increasing PA, CRF and QoL among survivors of cancer. MI resulted in the maintenance of all improvements achieved 3 months following programme completion.

Competitive level differences in the activity profile of elite Gaelic football referees.

The purpose of this study was to compare the activity profile of elite Gaelic football referees (GFR) between the National Football League (NFL) and the All-Ireland Championship (AIC), and across the four divisions of the NFL and three phases of the AIC. Match activity data was collected during 125 NFL and 201 AIC games using 10-Hz global positioning system technology from 41 elite GFR. Game duration, total distance, very low-speed movement (<0.70 m·s-1), walking (≥0.70-1.65 m·s-1), low-speed running (≥1.66-3.27 m·s-1), moderate-speed running (≥3.28-4.86 m·s-1), high-speed running (≥4.87-6.48 m·s-1), very high-speed running (≥6.49 m·s-1) distance, and peak running speed were compared between competitions. Games in the AIC were longer than in the NFL (ES = 0.59) but the total distance was similar between the NFL (119.6 ± 9.5 m·min-1) and AIC (122.6 ± 8.4 m·min-1, ES = 0.11). No other differences were found between the NFL and AIC or across the four divisions of the NFL and three phases of the AIC, except for a higher peak running speed during the All-Ireland Series (6.93 ± 0.52 m·s-1) than the All-Ireland Qualifiers (6.65 ± 0.46 m·s-1, ES = 0.35). This information can be used to design specific conditioning programmes to ensure optimal physical development of GFR at all competitive levels.

Activity profile of elite Gaelic football referees during competitive match play.

The purpose of this study was to examine the activity profile of elite Gaelic football referees (GFR) and to examine temporal changes between the first and second half and across the four quarters. Global positioning systems technology (10-Hz) was used to collect activity data during 202 competitive games from 23 elite GFR. Relative distance, peak running speed and relative distance covered in six movement categories [very low-speed movement (VLSM) (<0.70 m·s-1), walking (≥0.70-1.65 m·s-1), low-speed running (LSR) (≥1.66-3.27 m·s-1), moderate-speed running (MSR) (≥3.28-4.86 m·s-1), high-speed running (HSR) (≥4.87-6.48 m·s-1), very high-speed running (VHSR) (≥6.49 m·s-1)] were examined during the full game, first and second half, and across the four quarters. The relative distance covered was 122.6 ± 8.4 m·min-1, with 13.1 ± 4.9 m·min-1 of HSR and VHSR. The peak running speed was 6.75 ± 0.49 m·s-1. The relative (ES=0.60), MSR (ES=0.50) and HSR (ES=0.14) distance was higher in the first half than the second half. A higher relative (ES=0.62-0.91) and HSR (ES=0.51-0.61) distance was found in the first quarter than any other period. No differences in HSR distance were found between the second, third and fourth quarters (ES=0.04-0.10). This study provides, for the first time, a detailed insight into the activity profile of elite GFR during competitive games and demonstrates the demanding, intermittent nature of elite refereeing in Gaelic football. This information may be used as a framework for coaches to design training programmes specific to GFR.

Study protocol for the investigation of the clinical effectiveness of a physical activity behaviour change intervention for individuals living with and beyond cancer.

Most individuals living with and beyond cancer are not sufficiently active to achieve the health benefits associated with regular physical activity (PA). The purpose of this study was to describe the study protocol for a two-arm non-randomised comparison trial conducted within a community-based setting, which aimed to investigate the clinical effectiveness of a cancer-specific PA behaviour change (BC) intervention, namely MedEx IMPACT (IMprove Physical Activity after Cancer Treatment), compared to a general exercise rehabilitation programme, among survivors of cancer. Individuals who had completed active-cancer treatment who were referred to a community-based exercise rehabilitation programme were invited to participate in the trial. Participants in the control group (CG) attended twice-weekly supervised exercise classes for 12 weeks. Classes were delivered as part of a chronic illness exercise rehabilitation programme. Participants in the MedEx IMPACT intervention group (IG) also attended the twice-weekly supervised exercise classes for 12 weeks and received cancer-specific materials, namely an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation. The primary outcome was PA levels measured by 6-day accelerometry and self-report PA. Secondary outcomes included cardiorespiratory fitness (CRF), quality of life (QoL) and sedentary behaviour. Outcomes were measured at baseline and months 3, 6 and 12. Few effective PA BC interventions for individuals living with and beyond cancer have been identified. The results of this study will have implications for the planning and provision of community-based exercise oncology rehabilitation programmes for individuals living with and beyond cancer.

Using artificial intelligence to automate meat cut identification from the semimembranosus muscle on beef boning lines.

The identification of different meat cuts for labeling and quality control on production lines is still largely a manual process. As a result, it is a labor-intensive exercise with the potential for not only error but also bacterial cross-contamination. Artificial intelligence is used in many disciplines to identify objects within images, but these approaches usually require a considerable volume of images for training and validation. The objective of this study was to identify five different meat cuts from images and weights collected by a trained operator within the working environment of a commercial Irish beef plant. Individual cut images and weights from 7,987 meats cuts extracted from semimembranosus muscles (i.e., Topside muscle), post editing, were available. A variety of classical neural networks and a novel Ensemble machine learning approaches were then tasked with identifying each individual meat cut; performance of the approaches was dictated by accuracy (the percentage of correct predictions), precision (the ratio of correctly predicted objects relative to the number of objects identified as positive), and recall (also known as true positive rate or sensitivity). A novel Ensemble approach outperformed a selection of the classical neural networks including convolutional neural network and residual network. The accuracy, precision, and recall for the novel Ensemble method were 99.13%, 99.00%, and 98.00%, respectively, while that of the next best method were 98.00%, 98.00%, and 95.00%, respectively. The Ensemble approach, which requires relatively few gold-standard measures, can readily be deployed under normal abattoir conditions; the strategy could also be evaluated in the cuts from other primals or indeed other species.

A Methodology for Validating Diversity in Synthetic Time Series Generation.

In order for researchers to deliver robust evaluations of time series models, it often requires high volumes of data to ensure the appropriate level of rigor in testing. However, for many researchers, the lack of time series presents a barrier to a deeper evaluation. While researchers have developed and used synthetic datasets, the development of this data requires a methodological approach to testing the entire dataset against a set of metrics which capture the diversity of the dataset. Unless researchers are confident that their test datasets display a broad set of time series characteristics, it may favor one type of predictive model over another. This can have the effect of undermining the evaluation of new predictive methods. In this paper, we present a new approach to generating and evaluating a high number of time series data. The construction algorithm and validation framework are described in detail, together with an analysis of the level of diversity present in the synthetic dataset.

Pulmonary hypertension and home-based (PHAHB) exercise intervention: protocol for a feasibility study.

INTRODUCTION: Novel therapies for pulmonary hypertension (PH) have improved survival and slowed disease progression. However, patients still present with symptoms of exertional dyspnoea and fatigue, which impacts their ability to perform activities of daily living, reduces exercise tolerance and impairs their quality of life (QoL). Exercise training has shown to be safe and effective at enhancing QoL and physical function in PH patients, yet it remains an underused adjunct therapy. Most exercise training for PH patients has been offered through hospital-based programmes. Home-based exercise programmes provide an alternative model that has the potential to increase the availability and accessibility of exercise training as an adjunct therapy in PH. The purpose of this study is to investigate the feasibility, acceptability, utility and safety of a novel remotely supervised home-based PH exercise programme. METHODS: Single arm intervention with a pre/post comparisons design and a follow-up maintenance phase will be employed. Eligible participants (n=25) will be recruited from the Mater Misericordiae University Hospital PH Unit. Participants will undergo a 10-week home-based exercise programme, with induction training, support materials, telecommunication support and health coaching sessions followed by a 10-week maintenance phase. The primary outcomes are feasibility, acceptability, utility and safety of the intervention. Secondary outcomes will include the impact of the intervention on exercise capacity, physical activity, strength, health-related QoL and exercise self-efficacy. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Mater Misericordiae Institutional Review Board REF:1/378/2032 and Dublin City University Research Ethics DCUREC/2018/246. A manuscript of the results will be submitted to a peer-reviewed journal and results will be presented at conferences, community and consumer forums and hospital research conferences. TRIAL REGISTRATION NUMBER: ISRCTN83783446; Pre-results.

Maximal oxygen consumption and oxygen uptake efficiency in adolescent males.

BACKGROUND/OBJECTIVE: Measures of oxygen uptake efficiency (OUE) have been used to evaluate cardiorespiratory fitness (CRF) in adolescents unable to perform maximal exercise. The oxygen uptake efficiency slope (OUES) and oxygen uptake efficiency plateau (OUEP) have been proposed as surrogates for maximal oxygen consumption (V̇O2max). We assessed the validity of the OUES and OUEP as predictors of V̇O2max in healthy male adolescents. METHODS: Sixty-three healthy male adolescents aged 15.40 ± 0.34 years underwent an incremental treadmill test to determine V̇O2max, OUES and OUEP. OUE throughout the test was assessed by dividing each V̇O2 value by the corresponding minute ventilation (V̇E) value. OUEP was determined as the 90 s average highest consecutive values for OUE. OUES was determined using data up to the ventilatory threshold (VT) by calculating the slope of the linear relation between V̇O2 and the logarithm of V̇E. RESULTS: Limits of agreement for V̇O2max predicted by OUES (±13.3 mL kg-1.min-1) and OUEP (±16.7 mL kg-1.min-1) relative to V̇O2max were wide and a magnitude bias was found for OUES and OUEP as predictors of V̇O2max (p < 0.001). CONCLUSION: The OUES and OUEP do not accurately predict V̇O2max in male adolescents and should not replace V̇O2max when assessing CRF in this population.

Physical, psychological and nutritional outcomes in a cohort of Irish patients with metastatic peritoneal malignancy scheduled for cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC): An exploratory pilot study.

BACKGROUND: Treatment for peritoneal malignancy (PM) can include cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC) and is associated with morbidity and mortality. Physical, psychological and nutritional outcomes are important pre-operatively. The aim of this pilot study was to investigate these outcomes in patients with PM before and after CRS-HIPEC. METHODS: Between June 2018 and November 2019, participants were recruited to a single-centre study. Primary outcome was cardiopulmonary exercise testing (CPET) variables oxygen uptake (VO2) at anaerobic threshold (AT) and at peak. Secondary outcome measures were upper and lower body strength, health related quality of life (HRQoL) and the surgical fear questionnaire. Exploratory outcomes included body mass index, nutrient intake and post-operative outcome. All participants were asked to undertake assessments pre CRS-HIPEC and 12 weeks following the procedure. RESULTS: Thirty-nine patients were screened, 38 were eligible and 16 were recruited. Ten female and 6 male, median (IQR) age 53 (42-63) years. Of the 16 patients recruited, 14 proceeded with CRS-HIPEC and 10 competed the follow up assessment at week 12. Pre-operative VO2 at AT and peak was 16.8 (13.7-18) ml.kg-1.min-1 and 22.2 (19.3-25.3) ml.kg-1.min-1, upper body strength was 25.9 (20.3-41.5) kg, lower body strength was 14 (10.4-20.3) sec, HRQoL (overall health status) was 72.5 (46.3-80) % whilst overall surgical fear was 39 (30.5-51). The VO2 at AT decreased significantly (p = 0.05) and HRQoL improved (p = 0.04) between pre and post- CRS-HIPEC. There were no significant differences for any of the other outcome measures. CONCLUSION: This pilot study showed a significant decrease in VO2 at AT and an improvement in overall HRQoL at the 12 week follow up. The findings will inform a larger study design to investigate a prehabilitation and rehabilitation cancer survivorship programme.

The effect of participating in MedEx Wellness, a community-based chronic disease exercise rehabilitation programme, on physical, clinical and psychological health: A study protocol for a cohort trial.

BACKGROUND: Community-based exercise rehabilitation programmes for chronic disease are an effective alternative to traditional hospital-based programmes. MedEx Wellness is a novel community-based exercise rehabilitation programme that integrates a range of chronic diseases. The aim of this trial was to investigate the effect of participating in MedEx Wellness on physical, clinical and psychological health. METHODS: A prospective cohort study was conducted. Participants were recruited at induction to the MedEx Wellness programme following referral from healthcare professionals. Participants underwent a baseline assessment before commencing the exercise programme and repeat assessments at 3, 6 and 12 months. The primary outcome was cardiorespiratory fitness (6 minute- time trial) at 12 months. Secondary outcomes included health-related quality of life (EuroQoL-5D, Satisfaction with Life Scale, Warwick Edinburgh Mental Wellbeing Scale, Patient Health Questionnaire8, Functional Assessment of Cancer Therapy Questionnaire), free living activity behavior (accelerometer) and healthcare utilization (recall questionnaire). Tertiary outcomes included blood pressure (24 h), biomarkers (lipids, glucose and C-reactive protein), other components of physical fitness, including strength (handgrip test, sit-to-stand test), flexibility (sit-and-reach test), body composition (body mass index and waist-to-hip ratio), and falls risk (timed up and go test), and claudication time (incremental treadmill walking test), cognitive function, including attention (Attention Network Task), memory (Luck & Vogel Visual Working Memory Task) and cognitive reserve. Exploratory outcomes included psychosocial determinants of physical activity (self-efficacy, social support, intentions). DISCUSSION: This trial will evaluate whether participation in the MedEx Wellness programme has positive effects on physical, clinical and psychological health in individuals with a range of chronic diseases. TRIAL REGISTRATION: ISRCTN Registry ISRCTN10351412.

Benchmarking Parametric and Machine Learning Models for Genomic Prediction of Complex Traits.

The usefulness of genomic prediction in crop and livestock breeding programs has prompted efforts to develop new and improved genomic prediction algorithms, such as artificial neural networks and gradient tree boosting. However, the performance of these algorithms has not been compared in a systematic manner using a wide range of datasets and models. Using data of 18 traits across six plant species with different marker densities and training population sizes, we compared the performance of six linear and six non-linear algorithms. First, we found that hyperparameter selection was necessary for all non-linear algorithms and that feature selection prior to model training was critical for artificial neural networks when the markers greatly outnumbered the number of training lines. Across all species and trait combinations, no one algorithm performed best, however predictions based on a combination of results from multiple algorithms (i.e., ensemble predictions) performed consistently well. While linear and non-linear algorithms performed best for a similar number of traits, the performance of non-linear algorithms vary more between traits. Although artificial neural networks did not perform best for any trait, we identified strategies (i.e., feature selection, seeded starting weights) that boosted their performance to near the level of other algorithms. Our results highlight the importance of algorithm selection for the prediction of trait values.

The Youth-Physical Activity Towards Health (Y-PATH) intervention: Results of a 24 month cluster randomised controlled trial.

Low levels of physical activity in youth are an issue internationally, with the age related decline in levels over the adolescent period of particular concern. This study evaluated a multi-component school-based intervention (Y-PATH: Youth-Physical Activity Towards Health), focused on halting the age-related decline in physical activity of youth in early adolescence. A cluster randomized controlled trial in 20 post primary schools (10 control, 10 intervention) was conducted. Data were collected from all 20 schools at baseline (2013), and 12 months (2014), and from 10 of these schools (5 intervention) at 24 months (2015). The setting was mixed gender post primary schools residing in the greater area of Dublin, Ireland. Principals from each school were asked to nominate one first year class group attending their school in September 2013 to participate in the study (N = 564). Intervention schools implemented the Y-PATH whole school intervention, comprising teacher component, parent component, and PE component; while control schools continued with usual care. The main outcome measure was accelerometer derived average minutes of daily moderate to vigorous physical activity (MVPA). Data were analysed from October 2015 -November 2017. At baseline 490 participants were assessed (mean age 12.78y ± .42). Results of the multilevel regression analysis confirmed that there was a significant time intervention effect, and this was predominantly contributed by the difference between control and intervention groups within females. Findings support the case for national dissemination of the Y-PATH intervention so that the knowledge learned can be translated to routine practice in schools.

Comparison of Sprint Interval and Endurance Training in Team Sport Athletes.

Kelly, DT, Tobin, C, Egan, B, Carren, AM, O'Connor, PL, McCaffrey, N, and Moyna, NM. Comparison of sprint interval and endurance training in team sport athletes. J Strength Cond Res 32(11): 3051-3058, 2018-High-volume endurance training (ET) has traditionally been used to improve aerobic capacity but is extremely time-consuming in contrast to low-volume short-duration sprint interval training (SIT) that improves maximal oxygen uptake (V[Combining Dot Above]O2max) to a similar extent. Few studies have compared the effects of SIT vs. ET using running-based protocols, or in team sport athletes. Club level male Gaelic football players were randomly assigned to SIT (n = 7; 21.6 ± 2.1 years) or ET (n = 8; 21.9 ± 3.5 years) for 6 sessions over 2 weeks. V[Combining Dot Above]O2max, muscle mitochondrial enzyme activity, running economy (RE), and high-intensity endurance capacity (HEC) were measured before and after training. An increase in V[Combining Dot Above]O2max (p ≤ 0.05) after 2 weeks of both SIT and ET was observed. Performance in HEC increased by 31.0 and 17.2% after SIT and ET, respectively (p ≤ 0.05). Running economy assessed at 8, 9, 10, and 11 km·h, lactate threshold and vV[Combining Dot Above]O2max were unchanged after both SIT and ET. Maximal activity of 3-ß-hydroxylacyl coenzyme A dehydrogenase (ß-HAD) was increased in response to both SIT and ET (p ≤ 0.05), whereas the maximal activity of citrate synthase remained unchanged after training (p = 0.07). A running-based protocol of SIT is a time-efficient training method for improving aerobic capacity and HEC, and maintaining indices of RE and lactate threshold in team sport athletes.

Physiological Profile and Activity Pattern of Minor Gaelic Football Players.

Cullen, BD, Roantree, M, McCarren, A, Kelly, DT, O'Connor, PL, Hughes, SM, Daly, PG, and Moyna1, NM. Physiological profile and activity pattern of minor Gaelic football players. J Strength Cond Res 31(7): 1811-1820, 2017-The purpose of this study was to evaluate the physiological profile and activity pattern in club- and county-level under-18 (U-18) Gaelic football players relative to playing position. Participants (n = 85) were analyzed during 17 official 15-a-side matches using global positioning system technology (SPI Pro X II; GPSports Systems, Canberra, Australia) and heart rate (HR) telemetry. During the second part of this study, 63 participants underwent an incremental treadmill test to assess their maximal oxygen uptake (V[Combining Dot Above]o2max) and peak HR (HRmax). Players covered a mean distance of 5,774 ± 737 m during a full 60-minute match. The mean %HRmax and %V[Combining Dot Above]O2max observed during the match play were 81.6 ± 4.3% and 70.1 ± 7.75%, respectively. The playing level had no effect on the distance covered, player movement patterns, or %HRmax observed during match play. Midfield players covered significantly greater distance than defenders (p = 0.033). Playing position had no effect on %HRmax or the frequency of sprinting or high-intensity running during match play. The frequency of jogging, cruise running, striding (p = 0.000), and walking (p = 0.003) was greater in the midfield position than in the forward position. Time had a significant effect (F(1,39) = 33.512, p-value = 0.000, and (Equation is included in full-text article.)= 0.462) on distance covered and %HRmax, both of which showed a reduction between playing periods. Gaelic football is predominantly characterized by low-to-moderate intensity activity interspersed with periods of high-intensity running. The information provided may be used as a framework for coaches in the design and prescription of training strategies. Positional specific training may be warranted given the comparatively greater demands observed in the midfield playing position. Replicating the demands of match play in training may reduce the decline in distance covered and %HRmax observed during the second half of match play.

Validating a novel web-based method to capture disease progression outcomes in multiple sclerosis.

The Expanded Disability Status Scale (EDSS) is the current 'gold standard' for monitoring disease severity in multiple sclerosis (MS). The EDSS is a physician-based assessment. A patient-related surrogate for the EDSS may be useful in remotely capturing information. Eighty-one patients (EDSS range 0-8) having EDSS as part of clinical trials were recruited. All patients carried out the web-based survey with minimal assistance. Full EDSS scores were available for 78 patients. The EDSS scores were compared to those generated by the online survey using analysis of variance, matched pair test, Pearson's coefficient, weighted kappa coefficient, and the intra-class correlation coefficient. The internet-based EDSS scores showed good correlation with the physician-measured assessment (Pearson's coefficient = 0.85). Weighted kappa for full agreement was 0.647. Full agreement was observed in 20 patients who had EDSS scores ranging from 0 to 6; many of those with 100 % agreement had scores of 5.5-6 (n = 8).The intra-class coefficient was 0.844 overall for all cases. Internet-based FS and EDSS show good agreement with physician-measured scores. Agreement was better in patients with higher scores. Overall patient satisfaction with the web-based assessment was high. An internet-based assessment tool is likely to prove an invaluable tool in the long-term monitoring in MS.