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Updated: Aug 19, 2026
The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Real-life walking speed: A new marker of progression in a primary progressive multiple sclerosis cohort study?
Maeva Cotinat1, Christoph Heesen2, Ines Boudiaf1
1CRMBM, CNRS, Aix Marseille University, Marseille, France; CEMEREM, Hôpital Universitaire Timone, APHM, Aix Marseille University, Marseille, France; Physical and Rehabilitation Medicine Department, Hôpitaux Sud, APHM, Aix Marseille University, Marseille, France.
Background:
Primary progressive multiple sclerosis (PPMS) involves gradual disability accumulation driven by neurodegeneration. Standard outcomes, including the Expanded Disability Status Scale (EDSS) and timed 25-foot walk (T25FW), lack sensitivity to subtle functional changes. Real-life walking speed (RWS) measured with wearable sensors may offer a more responsive marker of progression.
Objectives:
In a prospective cohort (2012-2022) at the University Medical Center Hamburg-Eppendorf, adults with PPMS (18-65 years, EDSS ⩽7.0) underwent repeated EDSS, T25FW, Nine-Hole Peg Test (9HPT), and Symbol Digit Modalities Test (SDMT). RWS was recorded using an accelerometer. Disease progression was defined as ⩾20% worsening in T25FW/9HPT, ⩾8-point SDMT decline, EDSS increase (⩾1.0 or ⩾0.5 if >5), or RWS reduction >0.08 m/s.
Results:
Among 110 participants (mean age: 52 years; baseline EDSS: 3.5) followed for a median of 3 years, RWS showed a symmetric distribution and declined steadily with increasing EDSS, unlike the skewed T25FW distribution. Annual progression was detected in >30% of participants using RWS, compared with <20% for EDSS/SDMT and <10% for T25FW/9HPT. Composite endpoints including RWS identified earlier and more frequent disease progression (p < 0.01).
Conclusion:
Continuous RWS monitoring is more sensitive than conventional metrics for detecting functional decline in PPMS and may strengthen progression endpoints.
