Gait and six-minute walk performance in persons with multiple sclerosis

Area of Science:

• Neurology
• Rehabilitation Science
• Biomechanical Engineering

Background:

• The six-minute walk (6 MW) is a key measure of walking endurance in multiple sclerosis (MS), reflecting real-world mobility.
• Understanding factors influencing 6 MW performance is crucial for developing targeted interventions to improve community ambulation in MS.
• Gait characteristics may vary with disability level, necessitating a nuanced approach to rehabilitation.

Purpose of the Study:

• To investigate the role of cadence and stride length in explaining differences in 6 MW performance between individuals with MS and controls.
• To determine how the contribution of cadence and stride length to 6 MW performance varies across different levels of disability in MS.

Main Methods:

• A cohort of 256 individuals with MS and 49 non-MS controls completed the 6 MW test.
• Gait parameters, including cadence and stride length, were quantified using an electronic walkway during comfortable walking trials.
• Regression analyses were employed to assess the relationship between gait variables and 6 MW performance, stratified by disability level.

Main Results:

• Cadence and stride length were found to significantly explain differences in 6 MW performance between individuals with MS and controls.
• The relative contribution of cadence and stride length to walking endurance varied by disability severity in MS.
• In mild MS, stride length explained more variance in 6 MW performance than cadence, while in moderate-to-severe MS, both contributed more equally.

Conclusions:

• Gait variables, specifically cadence and stride length, are important determinants of walking endurance in MS.
• Intervention strategies aimed at improving walking endurance in MS should be tailored to the individual's level of disability.
• Optimizing gait parameters through disability-specific interventions holds promise for enhancing community ambulation in individuals with MS.