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Gait tests in multiple sclerosis: Reliability and cut-off values.

Pierre Decavel1, Thierry Moulin2, Yoshimasa Sagawa1

  • 1Laboratoire d'Exploration Fonctionnelle Clinique du Mouvement, University Hospital of Besançon, F-25000, Besançon, France; Integrative and Clinical Neurosciences EA481, Bourgogne Franche-Comte University, F-25000, Besançon, France.

Gait & Posture
|October 1, 2018
PubMed
Summary
This summary is machine-generated.

Gait measurement reproducibility in multiple sclerosis (MS) patients is crucial. Minimum detectable change (MDC95) values, exceeding clinical significance, indicate caution when interpreting gait parameter changes in MS.

Keywords:
ExerciseGaitMinimum detectable changeMultiple criteriaMultiple sclerosisReproducibility of results

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Area of Science:

  • Neurology
  • Rehabilitation Science
  • Biomedical Engineering

Background:

  • Gait limitation is a primary disability in multiple sclerosis (MS).
  • Gait parameters are used to assess therapy effectiveness, but their reproducibility is often unexamined.
  • Lack of reproducibility data may lead to overestimation of therapeutic effects.

Purpose of the Study:

  • To evaluate the reproducibility of gait measurements over short and long distances in individuals with MS.
  • To compare gait measurement reproducibility between MS patients and healthy controls.

Main Methods:

  • A cross-sectional study involving 58 MS patients and 19 healthy controls.
  • Gait tests included 25-foot walks (comfortable, fast, dual-task), Timed Up-and-Go (TUG), and 6-minute walk test (6MWT).
  • Measurements were repeated a week apart; reproducibility assessed using intra-class correlation coefficients (ICC) and minimum detectable change (MDC95).

Main Results:

  • Systematic error was absent only for fast-speed walking.
  • Reliability was moderate to high (ICC > 0.7) for most parameters, except dual-task cost (DTC = 0.45).
  • MDC95 values were higher in MS patients than controls, particularly for gait speed and TUG/6MWT (31.7%-51.5%). Stance time had the lowest MDC95 (6.8%) in MS patients, while DTC had the highest (158.7%).

Conclusions:

  • Minimum detectable change (MDC95) values for gait parameters in MS patients often exceed minimally important clinical difference (MICD) thresholds.
  • MDC95 should be prioritized over MICD for interpreting gait changes in MS clinical trials and practice.
  • Careful consideration of gait parameter reproducibility is essential for accurate assessment of interventions in multiple sclerosis.