Walking in MS: new outcomes

Wetzel et al. Six-minute walk test for persons with mild or moderate disability from multiple sclerosis: performance and explanatory factors. Physiother Can. 2011 Spring;63(2):166-80. Epub 2011 Apr 13. 

Purpose: The primary purpose of this study was to determine the extent to which health factors, functional measures, and pulmonary or lung impairment explain performance on 6-Minute Walk Test (6MWT) distance in ambulatory MS'ers. Another purpose was to determine the effect of disability and age on 6MWT performance and explanatory factors.

Methods: 64 MS'ers took part; 43 (67.2%) exhibited mild disability (EDSS <4.0) and 21 (32.8%) had moderate disability (EDSS 4.0-6.5). Different outcome measures were then assessed to document balance, mobility and lung function. 

Results: EDSS,  activities-specific balance confidence,  functional stair test,  sit-to-stand test, static standing balance,  maximal voluntary ventilation ,  maximal inspiratory pressure (breathing-in) and  maximal expiratory pressure (breathing-out) were significantly associated with 6MWT distance after adjusting for age. 
Conclusions: 6MWT performance in MS'ers was explained by balance confidence and stair-climbing ability. Activities-specific balance confidence and  functional stair test may be practical clinical measures for explaining walking ability and determining risk for disablement in MS'ers. 

"This study provides some additional context to walking problems in MS; in other words walking restriction is due to problems with balance and confidence. We kind of knew this but having it documented is important for us getting funding to treat people with MS on Fampridine. Our funders don't think the 25-foot timed walk is clinically meaningful; if we can show  that Fampridine improves the 6MWT and hence helps with confidence and stair-climbing; bingo!"

"We have a list of MS'ers keen to have a trial of Fampridine; this study will help us make an argument to get the drug funded."

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