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J C E Kempen¹, V de Groot, D L Knol

¹Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands. j.kempen@vumc.nl

Multiple Sclerosis (Houndmills, Basingstoke, England)

|May 31, 2011

Summary

Gait speed is linked to community walking ability in multiple sclerosis (MS) patients. However, a minimally important change in gait speed could not be established using the MFWC or EDSS criteria.

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Area of Science:

Neurology
Rehabilitation Medicine
Biomedical Engineering

Background:

Mobility decline is a hallmark of multiple sclerosis (MS).
Community walking scales assess independent ambulation in MS patients.
The Modified Functional Walking Categories (MFWC) is a key assessment tool.

Purpose of the Study:

To identify specific gait speeds corresponding to MFWC categories.
To determine the minimally important change (MIC) in absolute gait speed for MS.
To utilize MFWC and Expanded Disability Status Scale (EDSS) as external criteria for MIC determination.

Main Methods:

Longitudinal study of MS patients over six years.
Gait velocity measured using the 10-metre timed walk test (10-m TWT).

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MS severity assessed with EDSS; community walking with MFWC.

Receiver Operating Characteristic (ROC) curves used to define gait speed cut-offs for MFWC categories.

Main Results:

A significant correlation was observed between gait speed and MFWC categories (AUCs 0.74–0.86).
The minimally important change (MIC) in absolute gait speed could not be determined.
Area Under the Curve (AUC) values were below the 0.70 threshold, and gait speed changes were minimal.

Conclusions:

Gait speed is demonstrably related to community walking abilities in MS.
Establishing a minimally important change (MIC) in absolute gait speed was not feasible with the chosen external criteria (MFWC, EDSS).
Further research may be needed to refine MIC determination for gait speed in MS.