Ecological validity of walking capacity tests in multiple sclerosis

Area of Science:

• Neurology
• Rehabilitation Science
• Biomedical Engineering

Background:

• Ecological validity is crucial for clinical assessments to reflect real-life mobility.
• Short clinical gait tests (e.g., 10-meter) and 2- or 6-Minutes Walking Tests (2MWT/6MWT) are used in Multiple Sclerosis (MS) research.
• These tests are considered moderately associated with real-world mobility in MS patients.

Purpose of the Study:

• To evaluate the ecological validity of the 10 Meter Walking Test (10mWT), 2MWT, and 6MWT.
• To determine how well these clinical gait tests represent actual daily walking patterns in individuals with MS.

Main Methods:

• Participants with MS underwent 10mWT, 2MWT, and 6MWT.
• Ambulatory accelerometry was used to record walking patterns over seven days.
• Ecological validity was assessed by comparing test performance with real-life walking sequences and accelerometry data.

Main Results:

• In real life, uninterrupted walking for 2 or 6 minutes was infrequent (0.35-2.61 sequences/day).
• The 10mWT showed limited correlation with real-life walking speed quantiles.
• The 2MWT and 6MWT demonstrated moderate correlations with most real-life walking parameters.

Conclusions:

• Clinical gait tests covering short distances possess poor ecological validity in MS.
• The 2MWT and 6MWT exhibit moderate ecological validity.
• Ambulatory accelerometry can enhance the control and ecological validity of mobility outcome measures in MS.