Walking endurance in multiple sclerosis: Meta-analysis of six-minute walk test performance

Cederberg, Katie L.J.; Sikes, E. Morghen; Bartolucci, Alfred A.; Motl, Robert W.

doi:10.1016/j.gaitpost.2019.07.125

Cited by 38 publications

(18 citation statements)

References 40 publications

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“…The 6 min walking test was utilized for measuring the endurance walking capacity [ 37 ]. Patients were instructed to walk up and down on a 22 m walkway as far as possible in 6 min without encouragement, with the possibility to slow down and rest if necessary.…”

Section: Methodsmentioning

confidence: 99%

Rehabilitation Improves Mitochondrial Energetics in Progressive Multiple Sclerosis: The Significant Role of Robot-Assisted Gait Training and of the Personalized Intensity

et al. 2020

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Abnormal levels of pyruvate and lactate were reported in multiple sclerosis (MS). We studied the response of markers of mitochondrial function to rehabilitation in relation to type, intensity and endurance performance in severely disabled MS patients. Forty-six progressive MS patients were randomized to receive 12 walking sessions of robot-assisted gait training (RAGT, n = 23) or conventional overground therapy (CT, n = 23). Ten healthy subjects were also studied. Blood samples were collected to determine lactate, pyruvate, and glutathione levels and lactate/pyruvate ratio pre–post rehabilitation. In vivo muscle metabolism and endurance walking capacity were assessed by resting muscle oxygen consumption (rmVO2) using near-infrared spectroscopy and by six-minute walking distance (6MWD), respectively. The levels of mitochondrial biomarkers and rmVO2, altered at baseline with respect to healthy subjects, improved after rehabilitation in the whole population. In the two groups, an enhanced response was observed after RAGT compared to CT for lactate (p = 0.012), glutathione (<0.001), lactate/pyruvate ratio (p = 0.08) and rmVO2 (p = 0.07). Metabolic biomarkers and 6MWD improvements were exclusively correlated with a training speed markedly below individual gait speed. In severely disabled MS patients, rehabilitation rebalanced altered serum metabolic and muscle parameters, with RAGT being more effective than CT. A determinable slow training speed was associated with better metabolic and functional recovery. Trial Registration: ClinicalTrials.gov NCT02421731.

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Section: Methodsmentioning

confidence: 99%

Rehabilitation Improves Mitochondrial Energetics in Progressive Multiple Sclerosis: The Significant Role of Robot-Assisted Gait Training and of the Personalized Intensity

et al. 2020

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“…Although several studies have highlighted good reliability of the 6MWT score (i.e., the distance traveled in meters measured only one time at the end of the 6MWT) [16], little is known about the reliability of the ST variables across the 6MWT in PwMS with several measures during the 6MWT [27]. Moreover, to our knowledge, no study has analyzed the reliability of perceived exertion during the 6MWT (e.g., using the Borg scale).…”

Section: Introductionmentioning

confidence: 99%

“…They highlight motor fatigue resulting from extended task execution, thus, effectively assessing the physical efforts and level of autonomy of PwMS [12][13][14]. For these reasons, the prolonged tests are a better indicator of the ability of PwMS to perform the activities of daily living and have been evaluated for use in clinical practice and research [8,15,16]. Studies in PwMS [15,[17][18][19] and in other populations [20,21] have demonstrated that some walking variables measured during a 6MWT like walking velocity, cadence, or stride time could be altered across the 6MWT.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Prolonged Walking in Persons with Multiple Sclerosis: Reliability of the Spatio-Temporal Walking Variables during the 6-Minute Walk Test

Hadouiri

Monnet

Gouelle³

et al. 2021

Sensors

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Background: Walking disorders represent the most disabling condition in persons with Multiple Sclerosis (PwMS). Several studies showed good reliability of the 6-min walk test (6MWT) (i.e., especially distance traveled), but little is known about the reliability of the Spatio-temporal (ST) variables in the 6MWT. Objective: To evaluate the test-retest reliability of ST variables and perceived exertion during the 6MWT in PwMS and comparable healthy persons. Methods: We explored three 1-min intervals (initial: 0′–1′, middle: 2′30″–3′30″, end: 5′–6′) of the 6MWT. Six ST variables and perceived exertion were measured (respectively, using the GAITRite system and the Borg Scale). These measurements were performed twice, 1 week apart. The test-retest effects were assessed using the intraclass correlation coefficient (ICC) or the weighted kappa. Results: Forty-five PwMS and 24 healthy persons were included. The test-retest reliability of ST variables values was good-to-excellent for PwMS (ICC range: 0.858–0.919) and moderate-to-excellent for healthy persons (ICC range: 0.569–0.946). The test-retest reliability values of perceived exertion were fair for PwMS (weighted kappa range: 0.279–0.376) and substantial for healthy persons (weighted kappa range: 0.734–0.788). Conclusion: The measurement of ST variables during these 6MWT intervals is reliable and applicable in clinical practice and research to adapt rehabilitation care in PwMS.

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“…This fact could be observed in some of the figures created to show all the GPS data related to a given participant (e.g., Figure 5 ; see also all figures included in the OSF repository: , lastly updated on 17 April 2021), with a walking speed that sometimes fell to nearly 0 km/h where turns were steep. The fall in walking speed in such cases could reveal a strategy of the concerned participants to maintain balance in these situations, as it has been observed and explained during 6-min walking tests with courses including 180° turns [ 24 ]. This issue may have influenced the walking distances performed over the walking bouts and necessarily led to a decrease in mean walking speed over the concerned walking bouts.…”

Section: Discussionmentioning

confidence: 99%

Measuring Outdoor Walking Capacities Using Global Positioning System in People with Multiple Sclerosis: Clinical and Methodological Insights from an Exploratory Study

Delahaye¹,

Chaves²,

Congnard³

et al. 2021

Sensors

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We aimed at showing how Global Positioning System (GPS) along with a previously validated speed processing methodology could be used to measure outdoor walking capacities in people with multiple sclerosis (MS). We also deal with methodological issues that may occur when conducting such measurements, and explore to what extent GPS-measured outdoor walking capacities (maximal walking distance [MWDGPS] and usual walking speed) could be related to traditional functional outcomes (6-min total walking distance) in people with MS. Eighteen people with MS, with an Expanded Disability Status Scale score ≤6, completed a 6-min walking test and an outdoor walking session (60 min maximum) at usual pace during which participants were wearing a DG100 GPS receiver and could perform several walking bouts. Among the 12 participants with valid data (i.e., who correctly completed the outdoor session with no spurious GPS signals that could prevent the detection of the occurrence of a walking/stopping bout), the median (90% confidence interval, CI) outdoor walking speed was 2.52 km/h (2.17; 2.93). Ten participants (83% (56; 97)) had ≥1 stop during the session. Among these participants, the median of MWDGPS was 410 m (226; 1350), and 40% (15; 70) did not reach their MWDGPS during the first walking bout. Spearman correlations of MWDGPS and walking speed with 6-min total walking distance were, respectively, 0.19 (−0.41; 0.95) and 0.66 (0.30; 1.00). Further work is required to provide guidance about GPS assessment in people with MS.

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Walking endurance in multiple sclerosis: Meta-analysis of six-minute walk test performance

Cited by 38 publications

References 40 publications

Rehabilitation Improves Mitochondrial Energetics in Progressive Multiple Sclerosis: The Significant Role of Robot-Assisted Gait Training and of the Personalized Intensity

Rehabilitation Improves Mitochondrial Energetics in Progressive Multiple Sclerosis: The Significant Role of Robot-Assisted Gait Training and of the Personalized Intensity

Evaluation of Prolonged Walking in Persons with Multiple Sclerosis: Reliability of the Spatio-Temporal Walking Variables during the 6-Minute Walk Test

Measuring Outdoor Walking Capacities Using Global Positioning System in People with Multiple Sclerosis: Clinical and Methodological Insights from an Exploratory Study

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