The significant change for the Timed 25-Foot Walk in the Multiple Sclerosis Functional Composite

Abstract

The Timed 25-Foot Walk is under evaluation as a clinical tool to follow patients with MS. Several approaches have been taken to define a clinically significant change in this measurement. This study was undertaken to define the range of values expected for the Timed 25-Foot Walk and to correlate prospectively the change in walk-time that occurs during an exacerbation of MS associated with subjective difficulty walking. Five results from this study are emphasized. (1) Patients who were minimally affected by MS frequently walked 25 feet between three and five seconds. (2) the walk-time variability, defined as the ratio of the longest to the shortest walk-time, minus 1, times 100%, for three consecutive trials was generally 20% or less; (3) if the two fastest walk-times obtained in three trials were compared, the walk-time variability was almost always 10% or less; (4) for clinically stable individuals, the walk-times of single trials separated by 12 months or less generally varied less than 20%; and (5) patients who complained of difficulty walking, but who did not have changes otherwise detectable by examination, generally had a prolongation of walk-time. These results suggest that an increase of more than 20% in the Timed 25-Foot Walk may indicate a significant change in gait. Multiple Sclerosis (2000) 6 286 - 290

Rhythmic cued motor imagery and walking in people with multiple sclerosis: a randomised controlled feasibility study

“…Withdrawals or other reasons for exclusion from the study were recorded. For measures at baseline and follow-up, the Modified Fatigue Impact Scale (MFIS) [30, 31], the Timed 25-Foot Walk (T25FW) [32] and the 6-Minute Walk Test (6MWT) [33] were used. Baseline and follow-up assessments were performed at the same time of the day, in view of daytime fluctuations in fatigue.…”

Body-worn sensors capture variability, but not decline, of gait and balance measures in multiple sclerosis over 18 months

“…Yet typical clinical measures capturing gait and balance dysfunction are insensitive to mild disease or subtle worsening. For instance, at least 20% slowing in the walking time is required for the Timed 25 Foot Walk (T25FW) to be considered clinically significant (2). The Expanded Disability Status Scale (EDSS), a physician-administered global rating scale of MS neurological disability, is notoriously slow to detect change and prone to intra- and inter-rater reliability problems (3).…”

Measuring Disability Progression with the Multiple Sclerosis Functional Composite

“…It has been suggested that a 20% change in the 25FTW and 9HPT represents a reliably true change in function, whereas lower levels of change might represent clinically insignificant day-to-day fluctuations. 37 In addition, it has been suggested that an increase of more than 20% in the 25FTW or 9HPT also indicates a clinically significant impact on disability, as perceived by patients with MS. [38][39][40] However, the clinically relevant change in the overall MSFC score has not yet been determined. 41 This limits the usefulness of the MSFC as an outcome measure.…”

“…17 Finally, the clinical interpretation of changes in MSFC z-scores is unclear. Although clinically meaningful scores have been recommended for the components of the MSFC, [37][38][39][40] clinically meaningful scores for overall MSFC scores have not been established. 41 Thus, the MSFC has not been used as a primary outcome measure in clinical trials and is not useful in clinical practice.…”