Which walking capacity tests to use in multiple sclerosis? A multicentre study providing the basis for a core set

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Biomechanics

Background:

• Diverse walking capacity tests exist, creating ambiguity regarding their clinical information.
• Uncertainty surrounds whether short tests (walking speed) and long tests (walking distance) yield distinct clinical insights.

Purpose of the Study:

• To investigate the differential impact of short and long walk test formats on gait velocity.
• To determine the relationship between walking speed and walking distance in multiple sclerosis (MS) patients across varying ambulation statuses.

Main Methods:

• A cross-sectional, multicenter study involved 189 ambulatory MS patients (Expanded Disability Status Scale [EDSS] 0-6.5).
• Short tests included Timed 25-Foot Walk and 10-Metre Walk Test; long tests included 2- and 6-Minute Walk Tests.
• Patients were categorized into mild (EDSS 0-4) and moderate (EDSS 4.5-6.5) disability subgroups.

Main Results:

• Gait velocities significantly differed based on test protocol, instructed pace, and duration.
• Strongest correlations were observed between fastest walking speed and 6-Minute Walk Test distance (R²=0.78-0.81, p<0.01).
• The 2-Minute Walk Test demonstrated reduced estimation errors for 6-Minute Walk Test distance (approx. 5%) compared to short tests (8-16%).

Conclusions:

• A single short test at fastest speed adequately reflects general walking capacity in MS.
• Longer tests are advisable for intervention studies to assess walking distance.
• Recommend Timed 25-Foot Walk and 2-Minute Walk Test as standardized measures; further research on responsiveness is warranted.