Locomotor Strategy to Perform 6-Minute Walk Test in People with Multiple Sclerosis: A Prospective Observational Study

Area of Science:

• Neurology
• Rehabilitation Science
• Biomechanical Engineering

Background:

• Two-thirds of people with Multiple Sclerosis (PwMS) experience walking disabilities.
• Prolonged tests like the 6-minute walk test (6MWT) better assess everyday walking capacity and endurance in PwMS.
• Traditional 6MWT analyses primarily focus on distance, neglecting detailed walking pattern changes.

Purpose of the Study:

• To analyze and compare spatio-temporal (ST) walking patterns between PwMS and healthy individuals during the 6MWT.
• To determine if observed ST changes in PwMS are indicative of genuine walking ability decline or measurement variability.
• To assess the efficiency of rhythm management during prolonged walking in PwMS versus healthy controls.

Main Methods:

• Participants (45 PwMS, 24 healthy controls) performed a 6MWT.
• The GAITRite system measured five ST walking variables during three 1-minute intervals (initial, middle, and end) of the 6MWT.
• Statistical analysis compared ST variables across intervals and between groups, considering standard measurement error.

Main Results:

• PwMS exhibited significant changes in all ST parameters between the initial and final 6MWT intervals.
• Healthy individuals showed negligible changes between intervals, with a slight rebound pattern.
• ST variable changes in PwMS exceeded standard measurement error, confirming genuine alterations in walking patterns.

Conclusions:

• Walking pattern modifications in PwMS during the 6MWT are attributable to their condition, not measurement artifacts.
• PwMS demonstrate less efficient walking rhythm management compared to healthy individuals during sustained activity.
• Further research should explore early disease detection, clinical determinants, and intervention impacts on PwMS' walking patterns.