Carmela Leone1, Deborah Severijns2, Vendula Doležalová2, Ilse Baert2, Ulrik Dalgas3, Anders Romberg4, Francois Bethoux5, Benoit Gebara6, Carmen Santoyo Medina7, Heigo Maamâgi8, Kamila Rasova9, Benoît Maertens de Noordhout10, Kathy Knuts11, Anders Skjerbaek12, Ellen Jensen12, Joanne M Wagner13, Peter Feys2. 1. BIOMED, Hasselt University, Hasselt, Belgium Department of Neurosciences GF Ingrassia, University of Catania, Catania carmelaleone84@yahoo.it. 2. BIOMED, Hasselt University, Hasselt, Belgium. 3. Department Public Health, Section of Sport Science, Aarhus University, Aarhus, Denmark. 4. Masku Neurological Rehabilitation Center, Masku, Finland. 5. Mellen Center for MS Treatment and Research, Cleveland Clinic, Cleveland, OH, USA. 6. National MS Center, Melsbroek, Belgium. 7. Hospital de Dia de Barcelona CEMCat, Barcelona, Spain. 8. West-Tallinn Central Hospital, Tallinn, Estonia. 9. Department of Rehabilitation, Third Faculty of Medicine, Charles University in Prague, Czech Republic. 10. Centre Neurologique et de Réadaptation Fonctionelle Fraiture-en-Condroz, Begium. 11. Rehabilitation and MS Center, Overpelt, Belgium. 12. MS Hospitals Ry&Haslev, Denmark. 13. Saint Louis University, St. Louis, MO, USA.
Abstract
OBJECTIVE: To investigate the individual occurrence of walking-related motor fatigue in persons with multiple sclerosis (PwMS), according to disability level and disease phenotype.Study design This was a cross-sectional, multinational study.Participants They were 208 PwMS from 11 centers with Expanded Disability Status Scale (EDSS) scores up to 6.5. METHODS: The percentage change in distance walked (distance walked index, DWI) was calculated between minute 6 and 1 (DWI(6-1)) of the 6-Minute Walk Test (6MWT). Its magnitude was used to classify participants into 4 subgroups: (1) DWI(6-1)[≥5%], (2) DWI(6-1)[5%; -5%], (3) DWI(6-1)[-5%; > -15%], and (4) DWI(6-1)[≤-15%]. The latter group was labeled as having walking-related motor fatigue. PwMS were stratified into 5 subgroups based on the EDSS (0-2.5, 3-4, 4.5-5.5, 6, 6.5) and 3 subgroups based on MS phenotype (relapsing remitting [RR], primary progressive [PP], and secondary progressive [SP]). RESULTS: The DWI6-1was ≥5% in 16 PwMS (7.7%), between 5% and -5% in 70 PwMS (33.6%), between -5% and -15% in 58 PwMS (24%), and ≤-15% in 64 PwMS (30.8%). The prevalence of walking-related motor fatigue (DWI(6-1)[≤-15%]) was significantly higher among the progressive phenotype (PP = 50% and SP = 39%; RR = 15.6%) and PwMS with higher disability level (EDSS 4.5-5.5 = 48.3%, 6 = 46.3% and 6.5 = 51.5%, compared with EDSS 0-2.5 = 7.8% and 3-4 = 16.7%;P< .05). Stepwise multiple regression analysis indicated that EDSS, but not MS phenotype, explained a significant part of the variance in DWI(6-1)(R(2)= 0.086;P< .001). CONCLUSION: More than one-third of PwMS showed walking-related motor fatigue during the 6MWT, with its prevalence greatest in more disabled persons (up to 51%) and in those with progressive MS phenotype (up to 50%). Identification of walking-related motor fatigue may lead to better-tailored interventions.
OBJECTIVE: To investigate the individual occurrence of walking-related motor fatigue in persons with multiple sclerosis (PwMS), according to disability level and disease phenotype.Study design This was a cross-sectional, multinational study.Participants They were 208 PwMS from 11 centers with Expanded Disability Status Scale (EDSS) scores up to 6.5. METHODS: The percentage change in distance walked (distance walked index, DWI) was calculated between minute 6 and 1 (DWI(6-1)) of the 6-Minute Walk Test (6MWT). Its magnitude was used to classify participants into 4 subgroups: (1) DWI(6-1)[≥5%], (2) DWI(6-1)[5%; -5%], (3) DWI(6-1)[-5%; > -15%], and (4) DWI(6-1)[≤-15%]. The latter group was labeled as having walking-related motor fatigue. PwMS were stratified into 5 subgroups based on the EDSS (0-2.5, 3-4, 4.5-5.5, 6, 6.5) and 3 subgroups based on MS phenotype (relapsing remitting [RR], primary progressive [PP], and secondary progressive [SP]). RESULTS: The DWI6-1was ≥5% in 16 PwMS (7.7%), between 5% and -5% in 70 PwMS (33.6%), between -5% and -15% in 58 PwMS (24%), and ≤-15% in 64 PwMS (30.8%). The prevalence of walking-related motor fatigue (DWI(6-1)[≤-15%]) was significantly higher among the progressive phenotype (PP = 50% and SP = 39%; RR = 15.6%) and PwMS with higher disability level (EDSS 4.5-5.5 = 48.3%, 6 = 46.3% and 6.5 = 51.5%, compared with EDSS 0-2.5 = 7.8% and 3-4 = 16.7%;P< .05). Stepwise multiple regression analysis indicated that EDSS, but not MS phenotype, explained a significant part of the variance in DWI(6-1)(R(2)= 0.086;P< .001). CONCLUSION: More than one-third of PwMS showed walking-related motor fatigue during the 6MWT, with its prevalence greatest in more disabled persons (up to 51%) and in those with progressive MS phenotype (up to 50%). Identification of walking-related motor fatigue may lead to better-tailored interventions.
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Authors: Lars G Hvid; Tobias Gaemelke; Ulrik Dalgas; Mette K Slipsager; Peter V Rasmussen; Thor Petersen; Michael Nørgaard; Anders G Skjerbaek; Finn Boesen Journal: Mult Scler J Exp Transl Clin Date: 2021-02-17
Authors: Philipp Albrecht; Ingrid Kristine Bjørnå; David Brassat; Rachel Farrell; Peter Feys; Jeremy Hobart; Raymond Hupperts; Michael Linnebank; Jožef Magdič; Celia Oreja-Guevara; Carlo Pozzilli; Antonio Vasco Salgado; Tjalf Ziemssen Journal: Ther Adv Neurol Disord Date: 2018-10-05 Impact factor: 6.570