BACKGROUND: Ecological validity is an important psychometric property when assessing function. How a person with multiple sclerosis (MS) performs in clinical settings and in natural environments can be quite different. Walking is the most frequently assessed and recommended way to maintain health in a progressive disease such as MS. The objective was to estimate the extent to which clinical tests of walking capacity differ from real-world walking performance in people with MS. METHODS: Ninety-eight women and 27 men with MS were assessed using the 6-Minute Walk Test (6MWT) and wore an accelerometer for 7 consecutive days. Mean number of steps, mean number of steps at a brisk cadence or faster, and cumulative time per week spent walking at a brisk cadence or faster were regressed on 6MWT categories using quantile (median) regression. Contiguous steps were grouped into bouts of less than 5 minutes and 5 minutes or longer, and number of bouts 5 minutes or longer was regressed on 6MWT categories using a zero-inflated Poisson model. RESULTS: A total of 869 patient-days of accelerometer data were available. Mean total number of steps per day was greater for people with higher walking capacity (6MWT distance, ≥600 m). However, this group spent a small proportion of time walking at higher cadence bands. Compared with people with 6MWT distance of at least 600 m, people walking less than 500 m had approximately half the rate of walking bouts of 5 minutes or longer. Positive mood and fewer exercise barriers predicted more walking bouts of at least 5 minutes. CONCLUSIONS: Study participants with MS spent a small proportion of time walking at a health-promoting intensity.
BACKGROUND: Ecological validity is an important psychometric property when assessing function. How a person with multiple sclerosis (MS) performs in clinical settings and in natural environments can be quite different. Walking is the most frequently assessed and recommended way to maintain health in a progressive disease such as MS. The objective was to estimate the extent to which clinical tests of walking capacity differ from real-world walking performance in people with MS. METHODS: Ninety-eight women and 27 men with MS were assessed using the 6-Minute Walk Test (6MWT) and wore an accelerometer for 7 consecutive days. Mean number of steps, mean number of steps at a brisk cadence or faster, and cumulative time per week spent walking at a brisk cadence or faster were regressed on 6MWT categories using quantile (median) regression. Contiguous steps were grouped into bouts of less than 5 minutes and 5 minutes or longer, and number of bouts 5 minutes or longer was regressed on 6MWT categories using a zero-inflated Poisson model. RESULTS: A total of 869 patient-days of accelerometer data were available. Mean total number of steps per day was greater for people with higher walking capacity (6MWT distance, ≥600 m). However, this group spent a small proportion of time walking at higher cadence bands. Compared with people with 6MWT distance of at least 600 m, people walking less than 500 m had approximately half the rate of walking bouts of 5 minutes or longer. Positive mood and fewer exercise barriers predicted more walking bouts of at least 5 minutes. CONCLUSIONS: Study participants with MS spent a small proportion of time walking at a health-promoting intensity.
Authors: Catrine Tudor-Locke; Sarah M Camhi; Claudia Leonardi; William D Johnson; Peter T Katzmarzyk; Conrad P Earnest; Timothy S Church Journal: Prev Med Date: 2011-06-25 Impact factor: 4.018
Authors: Chris H Polman; Paul W O'Connor; Eva Havrdova; Michael Hutchinson; Ludwig Kappos; David H Miller; J Theodore Phillips; Fred D Lublin; Gavin Giovannoni; Andrzej Wajgt; Martin Toal; Frances Lynn; Michael A Panzara; Alfred W Sandrock Journal: N Engl J Med Date: 2006-03-02 Impact factor: 91.245
Authors: Valerie J Block; Matthew Waliman; Zhendong Xie; Amit Akula; Riley Bove; Mark J Pletcher; Gregory M Marcus; Jeffrey E Olgin; Bruce A C Cree; Jeffrey M Gelfand; Roland G Henry Journal: Front Neurol Date: 2022-05-23 Impact factor: 4.086